Umesh Shinde

In my role as Assistant Manager, I demonstrated proficiency in accurately applying incoming payments to customer accounts through SAP and MS Office tools.
My responsibilities extended to resolving payment discrepancies and meticulously reconciling accounts, ensuring the maintenance of precise and up-to-date financial records.
Moreover, I took on a leadership role in team management, overseeing and guiding a team in the execution of these financial processes. This collaborative approach facilitated a streamlined workflow and enhanced efficiency within the team. Additionally, I actively engaged with the finance team to investigate and resolve unidentified and misapplied payments, contributing to a comprehensive and accurate financial system.

Payment Processing and Financial Operations:

• Insurance and Patient Payments: Process checks for insurance and patients for the U.S. clients.
• Payment Posting: Post all lockbox payments using client lockboxes, credit card machines, and web payment portals.
• Transaction Review: Review and research transactions categorized as unpostable, unapplied, or unmatched, and reverse unpostable transactions in systems.
• Client Billing Systems: Post payments in client billing systems.
• Remittance Processing: Process patient payments and payer remittances (both electronic and paper), including performing 835 processing.
• Daily Targets: Achieve daily targets for payment posting transactions, including ERA and manual EOB posting.
• Claims Check: Verify claims once all processes are completed.
• AR Reporting: Run End of Day (EOD) AR reports to match gross totals in Cash Application or PMM.

Operational Management and Automation:

• Adjustments and Entries: Process entries to make adjustments and post to client accounts.
• Automation and Billing: Manage process-related automation, monthly billing, and maintain CCI.
• Leave Management: Oversee leave management and cross-skilling initiatives.
• Project Management: Manage multiple projects simultaneously, delivering results within tight deadlines while maintaining high quality.
• Interdepartmental Communication: Enhance communication between departments to facilitate faster decision-making processes.
• Process Automation: Lead process automation initiatives, significantly reducing manual efforts in day-to-day operations.
• Productivity Improvement: Improve team productivity through effective workflow strategies and time management techniques.
• Policy Development: Assist in developing operational policies and procedures aligned with organizational goals.
• System Support: Support supervisors and team members to maintain system functionality.
• Efficiency Improvements: Identify inefficiencies in current systems and recommend adjustments to increase productivity.
• Business Support: Contribute to business growth by providing recommendations based on market research and competitor analysis.
• Database Management: Create and manage operational databases to store and track data accurately.
• Process Optimization: Optimize operational efficiency by analyzing and streamlining processes.

Configuration of Benefit Operations:

• Enrollment and Clinical Rules: Configure member enrollment and clinical rules based on requirements.
• Data Analysis: Analyze prerequisites and completed data to ensure accurate coding and action completion.
• Excel Work: Utilize Excel for various tasks related to benefit operations.
• Quality Assurance: Conduct quality checks for coding activities across all related processes.
• Team Updates: Facilitate update-sharing sessions with the team.
• Training: Conduct process training for new team members.
• Team Meetings: Organize and lead team meetings and discussions.
• Operational Reporting: Create and maintain operational reports, including Error Consolidation, Quality, and Productivity metrics.
• Documentation: Develop and update user guides, reference manuals, SOPs, and training materials as needed.
• Process Automation: Collaborate with the Business Excellence (BE) team to automate processes and improve efficiency.
• Excel-Based Solutions: Provide Excel-based micro solutions to the BE team to reduce Average Handling Time (AHT).
• Client Consultation: Consult with the Client Account Executive to clarify and interpret items on patient charts, to prevent misinterpretations.
• Client Requirements: Verify client requirements and ensure accurate form submissions using multivariate analysis, business intelligence, data management, and predictive analytics.
• Client Queries and Automation: Address client queries and work on automating client tools to enhance data accuracy and processing speed.
• Objective Achievement: Ensure that both personal and team objectives are met, maintaining consistent service standards daily and monthly.
• Reporting: Prepare and publish various reports for the team and clients, including those related to Revenue Cycle Management (RCM), Accounts Receivable (AR), and medical billing.