Seeking a managerial position in Revenue Cycle Management (RCM) where I can leverage my extensive clinical and medical knowledge, proficiency in healthcare technologies, strong analytical skills, and exceptional organizational abilities to drive operational efficiency, improve financial performance, and enhance the overall quality of care within the organization.
Oversee end-to-end revenue cycle activities, including patient registration, insurance verification, coding, billing, claims submission, payment posting, denial management, and collections.
Manage and lead regional teams including billing specialists, coders, billers, Case Managers, Authorization.
Provide training, coaching, and performance reviews to improve staff efficiency and compliance.
Foster a collaborative and high-performance work environment.
Identify opportunities to streamline revenue operations and implement process improvements to reduce billing errors, claim denials, and delays.
Ensure compliance with regulatory requirements, payer policies, and internal controls.
Keep up-to-date with healthcare regulations, insurance policies, and billing standards.
Analyze financial reports, and revenue data to identify trends and areas for improvement.
Develop and implement strategies to maximize revenue and reduce the accrual percentage.
Collaborate with finance and accounting teams for accurate financial reporting.
Work closely with clinical, administrative, and IT teams to align revenue cycle initiatives with organizational goals.
Communicate regularly with regional leadership on revenue performance and challenges.
Group Revenue Optimization Manager
Burjeel Holding
04.2024 - 02.2025
Company Overview: CCRCM
Lead yearly budgeting processes focused on increasing revenue for both IP and OP services at the group level, ensuring alignment with organizational financial goals and enhancing cost-efficiency
Implement group-level documentation improvement initiatives to enhance the accuracy, completeness, and compliance of clinical records, driving improvements in quality metrics and reimbursement rates
Analyse denial trends across the group, developing and executing documentation improvement plans to address recurring issues and minimize claim denials, thereby increasing reimbursement and revenue
Conduct comprehensive case management analysis at the group level, identifying opportunities for process improvement, optimizing care coordination, and enhancing patient outcomes across multiple facilities
Collaborate with cross-functional teams, including clinical staff, operations leads, and finance, to align case management strategies with revenue cycle goals, ensuring better performance in metrics such as CMI, ARR, and ALOS
Act as a liaison between clinical teams and management to mitigate documentation gaps and ensure alignment with overall organizational goals related to revenue cycle management and care quality
Sharing the justifications to the payers for the high revenue cases from all the facility
Case Manager
LLH Musaffah & Lifecare Musaffah
02.2021 - 04.2024
Lead initiatives to enhance both IP and OP documentation, ensuring compliance with regulatory standards and improving clinical accuracy
Implement clinical documentation improvement strategies aimed at improving the quality and completeness of medical records, optimizing reimbursement, and enhancing patient care
Conduct concurrent case reviews for inpatient (IP) cases to improve the quality of clinical documentation, ensuring that care provided is appropriately captured in medical records
Perform cross-comparison analysis to evaluate documentation trends, identifying areas for improvement and developing new service line initiatives to enhance data accuracy
Act as a liaison between clinical teams and management to mitigate documentation gaps and ensure alignment with overall organizational goals related to revenue cycle management and care quality
Collaborate with operational leads and clinical teams to develop and execute project plans designed to improve key performance indicators (KPIs) such as CMI, ARR, ALOS and YPB
Senior Medical coder & Insurance Team Auditor
LLH Musaffah
06.2015 - 01.2021
Company Overview: Abu dhabi, United arab emirates
Responsible for coding DRG / day-care and submission & resubmission for the same
Dealing with insurance to obtain approval and justification for rendered service
Coordinating with treating physician for documentation improvement and medical necessity to meet the standard as per coding guidelines to avoid rejection in initial level
Software INSTA & 3M
Analysing the appropriate ICD-9CM, ICD-10CM and CPT codes for DRG files and using software like Encoder Pro, 3M to ensure the code assigned reflects to all activities of care rendered to the patient during the period of hospitalization
Analysing for rejected claims and ensure to do appropriate resubmission without delay
Abu dhabi, United arab emirates
Senior Medical Coding Auditor
e4e Health care Business Services Pvt Ltd
04 2013 - 05 2015
Company Overview: Kovilambakkam Chennai, India
Responsible for information from claims and medical records to verifying is billing accurate and follows standard practice guidelines
We will login to the CBIZ TACS, CITRIX and ALIFE SOFTWARES and will work on assigned documents
Analysing the appropriate ICD-9CM, ICD-10CM and CPT codes using the Code finder software like Encoder Pro, 3M to ensure the code assigned reflects to all activities of care rendered to the patient during the period of hospitalization
Associate the diagnosis codes to the appropriate procedure codes (CPT) and sequence the codes in such a way as to ensure proper reimbursement
Responsible for coding various specialties which include E/M, Inpatient, outpatient, emergency department, radiology and anaesthesia and HCC
Respond professionally to all provider inquiries
Kovilambakkam Chennai, India
Medical Records coder Senior Representative
Dell International Services Pvt Ltd
03 2012 - 03 2013
Company Overview: Chennai, India
Responsible for coding and auditing the charts using electronic medical record system
Meet the productivity targets of clients within the stipulated time
Prepare and Maintain status reports
We will login to the Zotec software and ALIFE SOFTWARES and will work on assigned documents
Validate the accuracy of Radiology and IVR reports
Evaluate medical records and charge tickets to ensure completeness, accuracy and compliance with ICD-9-CM and to optimize reimbursement by ensuring that diagnostic and other documentation accurately reflect and support the patient visit and to ensure that data comply with coding guidelines.
Medical Coder Analyst
Visionary RCM Pvt Ltd
08.2010 - 02.2012
Validate the accuracy for HCC Reports (well point and atena)
Analysing the appropriate ICD-9CM codes using the Code finder software like Encoder Pro, 3M to ensure the code assigned reflects to all activities of care rendered to the patient during the period of hospitalization
Auditing for HCC (well point in client side)
Education
B.Pharm. -
Dr.M.G.R University
HSSC - undefined
Jayankondam
Certification
Certified Professional Coder (CPC)
ICD-10-CM Certified Coder from AAPC, 01332501
Certified Professional Medical Biller (CPMB)
Languages
English
Fluent
Tamil
Native
Personal Information
Custom
This is to certify that the above mentioned information is true to the best of my knowledge and belief.