Suresh TG

Professional Experience
Service Delivery Department Head
Billed Right Healthcare Solutions Pvt Ltd (2009-Present)

- Over 18 Years of Expertise: Specialized in medical billing with a focus on Internal Medicine, Cardiology, Psychiatry, Gastroenterology, and Pain Management.

- Leadership in Service Delivery: Currently managing the Service Delivery department for the past 10 years, overseeing a dedicated team and ensuring operational excellence.

- Strategic Planning and Execution:
- Conduct scorecard maintenance, weekly L10 meetings, and monthly meetings for effective team communication.
- Drive quarterly initiatives (Rocks) and present progress to the Management during Quarterly meetings.

- Team Development and Performance Management:
- Conduct one-on-one meetings with team members, understanding their strengths and weaknesses.
- Address internal and external issues, actively participating in client meetings, and resolving RCM concerns.

- Data Analysis and Knowledge Sharing:
- Perform data analysis for practices, providing valuable feedback to enhance practice growth.
- Conduct Knowledge-sharing sessions for team leads and managers, fostering continuous learning.

- Employee Engagement and Recognition:
- Maintain department attrition and boost morale through Rewards and Recognition initiatives.
- Actively participate in the annual Summit, contributing to the overall success of the organization.

- Strategic Collaboration and Compliance:
- Collaborate with senior management on long-term strategic planning initiatives.
- Enforce departmental policies, procedures, and ensure compliance with state and federal laws.

- Operational Efficiency and Automation:
- Implement quality control measures throughout product development, reducing costs and enhancing efficiency.
- Improve department operations through the successful implementation of automation.

- Leadership and Team Building:
- Provide leadership during times of crisis or change, maintaining productivity levels.
- Cultivate a culture of empowerment and innovation, promoting employee engagement.

- Performance Evaluation and Recruitment:
- Conduct performance evaluations, providing guidance for improvement.
- Recruit qualified candidates, ensuring the organization's talent pool aligns with business goals.

- Effective Communication and Stakeholder Management:
- Maintain effective communication with external vendors and stakeholders.
- Establish key performance indicators, measuring departmental effectiveness.

• Performed patient demographic Entry, Insurance Eligibility Verification, Charge posting and Traninsurance veritasks to update customer records and maintain accuracy of information.
• Maintained accurate records of all transactions related to processes in accordance with company guidelines.

• Analyzed denials from various payers to identify root causes.
• Implemented corrective actions to prevent recurring denials.
• Action taken for the clearinghouse rejections
• Worked on AR follow up claims (>30 days Outstanding claims)
• Detailed review for Refund request and Open Credits
• Managed the generation and distribution of patient statements
• Prepared comprehensive month-end reports and shared with the client.

• Quality Audit for Charges and Payment Posting for both ERA & Manual Posting.

• Performed patient demographic Entry, Insurance Eligibility Verification, Charge Posting and Claims Transmission.