SUMANDEEP SIRIGIRI

Responsibilities/Duties include:

• Managed various facilities across California market in PrimEra as a Team Leader and got promoted as Assistant Manager.
• CHMC, SRMC, PVH, AHMC, EHMC & SFMC are the facilities handled in California market.
• Proactively transitioned SB OP AR for 5 facilities (CHMC, SRMC, PVH, AHMC & EHMC).
• Currently overseeing HB OP AR for SFMC located in California.
• Trained 13 individuals on California market specifics.
• Managing a team of 6 members, supported by 1 Team Leader.
• Prompt return and follow up to all interactions prompt response to requests for information, both internally and externally.
• Perform revenue Analytics for work order trends to optimize production, collections & denial reduction.
• Eliminate non-collectable aspects to streamline operations and improve overall performance.
• Proficient in EDI Reports (EDI 837, 276, 277 & 835) which helps in allocation and identifying of any payor collection issues & denial trends.
• Perform audits on High $ and High Age claims for optimal resolution.
• Identified automation opportunities, implemented RPA for eligibility extraction & Claim Status.
• Maintained consistency in Collections by periodical identification of payer issues/trends and discussing the same with CBO.
• Identifying and Grooming SMEs for the next level.
• Auditing the patient letters for the process which are being shared with CBO & having them changed based on the scenario.
• Identify the trends/issues through report level and by manual review to have those processed without the intervention of the Collectors which will increase the throughput. Ex: Underpayment and Backend adjustments.
• GCR Initiatives- Paper to electronic conversion for fast cash. Angeles, Dignity & Noble are the 3 payers which were identified and have assisted in successfully setting up the electronic mode for claims submission.
• Ability to oversee the duties of the payment entry specialist and AR specialist.
• Complies and enforces all policies and procedures related to the position, the department and the company.

Responsibilities / Duties Include:

• Championed as a Collections Specialist handling 2 big payers on the island (Guam).
• Carried out follow ups with multiple Employers for Workers Compensation claims.
• Created a strong rapport with the Payer reps/Adjudicators so that 90% of the claims issues were solved over the emails.
• Maintained a success rate of 100% for the Good cause appeals by attaching the appropriate proofs with clear documentation (appeal letter).
• Streamlined the contracts for commonly used codes which were repetitive and had to be included in the contract by constantly following up with the Provider relations team and the Onshore team (Providers office).
• Praised by the Onshore team for consistent & timely response to claim balance settlements within the TAT of 5 days from the denial date.
• Trained a batch of 2 new freshers in RCM.

• Minimized financial risks with thorough analysis of customer payment patterns and credit history.
• Reduced credit balance discrepancies by regularly monitoring accounts and identifying errors.
• Assisted in training new employees on proper techniques for managing credit balances, ensuring smooth integration into the team environment.
• Assisted in training a batch of 9 freshers in identifying the correct responsible party for Credit & helping them either refund the payer or by filling the Credit balance sheets for patient.
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• Maintained strict compliance with HIPAA, CMS, and payer-specific guidelines during payment posting activities.
• Reduced manual data entry errors with accurate payment postings and account reconciliations.
• Expedited month-end close procedures through efficient coordination with billing and finance teams.
• Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
• Identified trends in payer denials and collaborated with other departments to resolve recurring issues proactively.
• Ensured timely reimbursement through meticulous claims adjustments and denials management.
• Provided valuable insights during departmental meetings that led to continuous improvements in the payment posting process.
• Enhanced team productivity by training new specialists on payment posting procedures and best practices.
• Collaborated closely with coding specialists for accurate charge capture, enabling timely and complete reimbursement from payers.