Viral Prashant Patil
AR Executive
Summary
Professional Summary
- CMC Certified Coder with 2 years of experience in medical billing, denial management, claim follow-up, and eligibility verification.
- Skilled in Epic, AdvancedMD, Salesforce, and streamlining billing workflows and reducing claim denials.
- Proven record of improving revenue cycle efficiency and maintaining compliance with insurance guidelines.
- Strong communicator with experience in handling payer interactions, appeals, and patient inquiries.
- Experienced in analyzing claim denials and implementing process improvements to reduce recurring issues.
- Adept at working in fast-paced, deadline-driven environments, ensuring high accuracy and productivity in billing operations.
- Seeking to contribute expertise in Revenue Cycle Management (RCM) to healthcare organizations in Malaysia.
Overview
2
2
years of professional experience
3
3
Languages
Work History
Senior Executive Operations
Credence Resource Management
05.2024 - Current
- Verified patient insurance coverage and eligibility with providers, ensuring 100% accuracy in patient demographic updates.
- Reduced claim rejections by 12% through proactive Eligibility Verification and coverage validation.
- Maintained up-to-date knowledge of insurance regulations, ensuring zero compliance issues during audits.
- Leveraged experience from previous AR/billing roles to handle end-to-end claim cycle, including account follow-ups, discrepancy resolution, and updating insurer information.
- Improved claim settlement rate by 15% by implementing best practices learned from prior roles in AR and insurance operations.
Senior Client Partner
Access Healthcare
10.2023 - 05.2024
- Processed 45+ claims daily with 95% accuracy, consistently meeting client SLAs.
- Improved denial resolution rate by 15% through root cause analysis and timely resubmissions.
- Handled patient billing inquiries, achieving 90% first-call resolution.
- Streamlined charge entry and payment posting, reducing processing time by 10%.
- Acted as a bridge between healthcare providers and insurers, enhancing communication efficiency.
- Drew on prior AR and insurance operations experience to reduce outstanding receivables by 20% and minimize documentation errors.
- Enhanced payer communication protocols by integrating lessons from earlier roles, reducing delays in claim approvals.
Education
Bachelor of Science - Biotechnology
Shivaji University
04.2001 -
HSC - undefined
Sanskar Dham College Of Science And Commerce
01.2018
SSC -
Utkarsh Vidya Mandir
01.2016
Skills
- Revenue Cycle Management (RCM) – End-to-end billing, claim submission, and collections
- Denial Management – Root cause analysis, resubmissions, appeals
- Eligibility & Pre-Authorization – Insurance eligibility verification, pre-certification checks
- Payment Posting & Charge Entry – Accurate claim data entry, payment reconciliation
- Insurance Communication – Liaison with payers, patients, and providers for claim resolution
- Compliance & Accuracy – Knowledge of insurance guidelines, HIPAA, and medical coding standards
- Billing Software Expertise – Epic, AdvancedMD, Salesforce
Interests
Cooking, singing
Timeline
Senior Executive Operations
Credence Resource Management
05.2024 - Current
Senior Client Partner
Access Healthcare
10.2023 - 05.2024
Bachelor of Science - Biotechnology
Shivaji University
04.2001 -
HSC - undefined
Sanskar Dham College Of Science And Commerce
SSC -
Utkarsh Vidya Mandir
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