Vijay Kumar Chengal
Bangalore
Summary
Experienced RCM professional with 8 years managing end-to-end billing operations, leading a 25+ member team across sub-processes. Proven expertise in process optimization, client relations, automation, team leadership, and consistently exceeding performance benchmarks.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Senior Consultant
Health Prime
Bangalore
12.2022 - Current
- Lead a 25+ member team across RCM processes including Rejections, Collections, and Appeals.
- Manage daily operations to achieve KPIs like AR reduction and denial resolution.
- Coordinate with clients and internal teams to resolve escalations and align goals.
- Conduct root cause analysis and implement process improvements for recurring issues.
- Prepare and present productivity, quality, and performance reports to leadership.
- Drive automation projects including Clearinghouse and Eligibility Response automation.
- Oversee team training, onboarding, and compliance with HIPAA and company policies.
- RPA Migration − Led coordination with BPO & IT teams.
- 277 ANSI Eligibility Response Mapping
- Eligibility Response Automation
- Optum IEDI Portal Enhancements
- Clearinghouse Rejection Automation − Availity & Optum IEDI
- Identified AR trend solutions with BPO for improvement
- Led client engagement meetings to gather requirements and understand project needs.
- Analyzed data trends to identify areas for process enhancement in healthcare delivery.
- Collaborated with cross-functional teams to implement technology solutions for clients.
- Mentored junior consultants in best practices and effective client communication strategies.
- Collaborated with cross-functional teams throughout the organization to ensure alignment of objectives.
- Directed and coordinated work completed by junior consultants and other consultants.
- Monitored progress of ongoing projects to ensure objectives were met within specified time frames.
- Developed training materials and conducted trainings for staff members on new technologies or processes.
- Created reports, presentations and other documents to share findings with management team.
- Prepared comprehensive project status updates including risks, issues, timeline changes.
- Managed multiple client engagements simultaneously while adhering to tight deadlines.
- Provided technical advice to support implementation of new initiatives or programs.
- Worked closely with stakeholders to identify business issues.
- Partnered with senior executives to identify key performance indicators for measuring success.
- Developed detailed project plans and timelines to ensure successful completion of projects.
- Facilitated workshops with stakeholders to review current procedures and develop new processes.
Senior Analyst
Health Prime
Bangalore
08.2018 - 12.2022
- Collaborated with cross-functional teams to develop comprehensive reporting frameworks.
- Presented findings to stakeholders, facilitating informed strategic planning discussions.
- Trained junior analysts on methodologies and tools for data interpretation and analysis.
- Managed project timelines, ensuring alignment with organizational goals and objectives.
- Developed training materials for end users.
- Collaborated with team members to develop project goals and timelines.
- Participated in team meetings to discuss project updates and challenges.
- Prepared reports summarizing findings from data analyses.
- Collaborated with other teams to ensure accuracy of collected data across departments.
- Identified areas of improvement within existing systems by analyzing current procedures and user feedback.
- Engaged in continuous learning to stay updated on new data analysis tools and techniques.
- Engaged with external vendors and consultants on data integration projects.
- Managed diverse projects for data capture, storage and forecast analysis.
- Managed customer accounts and ensured timely collections of outstanding invoices.
- Monitored aging reports and followed up on overdue accounts regularly.
- Trained new staff on accounts receivable procedures and software systems.
- Performed research into disputed invoices or payments as needed.
- Reviewed and reconciled customer accounts to ensure accuracy of invoices and payments.
- Conducted regular reviews of unapplied cash transactions to ensure proper application of funds.
- Processed incoming cash receipts in accordance with company policies.
- Prepared monthly reports summarizing account activity including aging analysis and outstanding balance summaries.
- Maintained accurate records of all account receivable activities for audit purposes.
- Resolved discrepancies between customer records and bank statements.
- Updated existing credit information on existing customers as needed based on changes in their financial status.
- Communicated with internal and external auditors to explain and support processes and reconciliations.
- Investigated customer complaints regarding billing issues and resolved disputes promptly.
- Reconciled computer reports with manually maintained ledgers.
AR Trainee
Health Prime
Bangalore
12.2016 - 08.2018
- Participated in training sessions to enhance knowledge of healthcare regulations.
- Worked alongside senior team members to learn related job tasks and roles.
- Attended training sessions and meetings to learn new information and develop personal skills.
- Maintained positive working relationship with fellow staff and management.
- Assessed company operations for compliance with safety standards.
- Monitored operations and reviewed records and metrics to understand company performance.
- Analyzed key performance indicators to identify effective strategies.
Education
Bachelor of Commerce -
Presidency College
Skills
- Excel (VLOOKUP, Pivot Tables)
- PowerPoint
- Outlook
- Emdeon Office
- Optum IEDI
- Availity Portal
- Clearinghouse Portals
- Google Workspace (Sheets, Docs, Meet)
- ANSI 277/EDI Transactions
- Claim Scrubbing Tools
- Denial Management Systems
- AR Reporting Dashboards
- RPA (basic involvement)
- HIPAA Compliance Tools
- EHR/EMR System
- Team leadership
Certification
- RCM Certification − Completed through Healthcare Performance Improvement (HPI)
- Lean Six Sigma − Problem Solving Training
Accomplishments
- Consistently rated 'Exceeds Expectations' in annual performance reviews
- Honored with the Outstanding Performance Award as Senior Consultant
- Recipient of the Client Success Award for delivering impactful results
Projects Initiatives
- RPA Migration − Led coordination with BPO & IT teams.
- 277 ANSI Eligibility Response Mapping
- Eligibility Response Automation
- Optum IEDI Portal Enhancements
- Clearinghouse Rejection Automation − Availity & Optum IEDI
- Identified AR trend solutions with BPO for improvement
Languages
English
Advanced
C1
Hindi
Advanced
C1
Telugu
Elementary
A2
Tamil
Elementary
A2
Kannada
Beginner
A1
Personal Milestones and Achievements
- Served as President of ROTARACT Club of Presidency.
- Dual Member of Rotary Raj Mahal Vikas
- Served as Joint secretary Rotary RMV
- Community Service Director - RAC RMV
- Active Participation in Environmental Protection and Management.
- Organising Blood Donation Camps
- Event Management.
- Team Management and Bonding Excercises
Timeline
Senior Consultant
Health Prime
12.2022 - Current
Senior Analyst
Health Prime
08.2018 - 12.2022
AR Trainee
Health Prime
12.2016 - 08.2018
Bachelor of Commerce -
Presidency College