Udaya Kumar
Bengaluru
Summary
Experienced RCM & AR Professional. Dedicated and results-driven professional, with expertise in end-to-end Revenue Cycle Management (RCM) processes. Skilled in AR management, customer service, and team training. Proven track recorProven track record in handling eligibility and benefits verification, denial management, claims rejections, prior authorizations, appeals, reconsideration letters, and correspondence analysis. Service in healthcare billing operations. Healthcare professional with experience in managing accounts receivable tasks, including verifying insurance claims, and resolving discrepancies.. Adept at communicating with insurance companies and patients to ensure timely payments and maintain accurate records. Strong organizational skills and attention to detail in handling sensitive financial information.
Overview
13
13
years of professional experience
Work History
Program Specialist
Neovance
Bengaluru
10.2023 - Current
- Delivered exceptional service by resolving patient inquiries with accuracy.
- Managed detailed benefit verifications, ensuring clear coverage details as per the program SOP.
- Maintained ongoing communication with insurance representatives, healthcare providers.
- Executed insurance benefit verifications for commercial and government payers via phone and online.
- Identified primary and secondary payers while adhering to HIPAA regulations.
- Ensured confidentiality of patient accounts and financial information.
- Processed prior authorizations efficiently to ensure timely access to prescribed medications.
- Communicated effectively with healthcare providers regarding patient benefit inquiries.
- Conducted thorough benefits verification, achieving a 98% accuracy rate in eligibility determinations.
- Communicated insurance coverage details and copay structures to patients and providers effectively.
Sr. AR Caller
Legacy Med Healthcare PVT LTD
Chennai
08.2021 - 09.2023
- Handling client accounts.
- Oversaw day-to-day operations and performance management of a team of members in a fast-paced environment.
- Part of the client review for various accounts is conducted on a monthly basis.
- Trained junior staff on best practices in accounts receivable management.
- Attending calls from the onshore team to discuss the daily trends and issues.
- Collaborated with team members to achieve target results.
- Achieved service time and quality targets.
- Picked up additional tasks to aid the team's success.
- Maintain communication with payers (insurance) via telephone or the payer website if we need any information regarding the check number, date of payment, etc.
AR Caller/Analyst
Global Health Billing Partners
Chennai
08.2015 - 06.2021
- Inducting different micro-level processes of RCM, like AR follow-up, denial management, ERA (electronic remittance advice) management, appeal, and grievance.
- Focus on resolving the denial and rejection, rather than writing off the amount.
- Priority is given to high dollars and sensitive cases for those whose TFL is about to expire.
- Work for providers' based billing; if any issues are raised in billed claims, then recreate the claim with the correct information and void the previous claim.
- Client interaction on a weekly, monthly, and quarterly basis regarding the workflow.
Process Associate
Omega Healthcare PVT LTD
Chennai
03.2013 - 01.2014
- Receive and verify requests for prior authorizations and ensure that they are administered properly.
- Consult with presiding doctors or nurse managers to obtain clearance for the necessity of treatment.
- Look through insurance plans in a detailed manner and process required referrals.
- Sort medical records and submit them to the carrier in a bid to expedite the authorization process.
- Keep medical staff in the loop about any delays or problems in obtaining authorizations.
- Ascertain that insurance carriers' documentation requirements are completed and that all copies are placed in patients medical records files.
Education
Bachelor of Science - Mathematics, Statistics, and Computer Science
VCR Degree College
Chittoor, APMPC - Mathematics, Physics And Chemistry
Narayana Junior College
Chittoor, AP01-2009
SSLC -
Kings English Medium High School
Chittoor, APSkills
- Healthcare
- Coordination with payors (eg, Medicare, Medicaid, and commercial insurers)
- Accounts receivable calling
- Appeals and resubmissions
- Insurance eligibility verification
- Prior authorization handling
- Compliance with HIPAA guidelines
- Knowledge of US healthcare terminologies and payor guidelines
- Communication skills
- Deadline management
Hobbies and interests
- Cricket
- Badminton
Social networks
https://www.linkedin.com/in/udayakumargv
Timeline
Program Specialist
Neovance
10.2023 - Current
Sr. AR Caller
Legacy Med Healthcare PVT LTD
08.2021 - 09.2023
AR Caller/Analyst
Global Health Billing Partners
08.2015 - 06.2021
Process Associate
Omega Healthcare PVT LTD
03.2013 - 01.2014
Bachelor of Science - Mathematics, Statistics, and Computer Science
VCR Degree College
MPC - Mathematics, Physics And Chemistry
Narayana Junior College
SSLC -
Kings English Medium High School
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