Manager Medical Billing
Resume:
RESUME
D. Mohan Raj No.**,
*th Street, Rajaji Nagar,
Villivakkam, Chennai - 600 049.
Tamil
Nadu, India.
Mobile: 984*******/
E-Mail: **********@*****.***
Objective:
To be part of a competitive work environment and perform to the best
of my ability towards the growth of the organization and work towards
continuous self-development.
Educational Qualification:
Graduation in Bachelor of Commerce - (1997- 2000) - Madras University
Technical Qualification:
AMCB (advanced medical coding & billing) - (Aug'2013 - Nov'2013) - Aldos,
chennai.,
Experience:
TBS2, Chennai (Dec 2013 to Till date)
Joined as 'Manager' to manage and handle Medical Billing Back end and
outsourced team (vendors) for different clients. primary duties involved
running AR and specific reports periodically, align and allocate
internally and externally, audit the reports received from vendors on
regular basis, update and train them if any global issues arrived, active
participation in execution of various quality improvement strategies for
continual improvement in services and TAT's (Turn Around time). Accountable
for reviewing processes on a regular basis and developing SOP. Preparing
and generating reports for tracking performance/profitability and
submitting the same to top management.
P1 Billing (July 2011 to Aug 2013)
Joined as Assistant Manager in Bangalore operations, my duties involved.
Handling denial team and trained the team members in analysis and calling
process to clear up AR backlogs to streamline the process. Maintain TAT
(turn around time). Weekly team meeting and training for the team members.
Update the client specific document and team member's periodically.
During my period, based on my work performance I promoted as "Operation
Manger - Billing" and moved to Chennai operations to setup and handle AR
team. I did complete process transition from US and BLR branch. Taking
interview for billing team, prepared billing process training documents
based on the requirement. Class room training for the fresher's batches and
live training for experience/fresher's in the production floor...Conduct
periodical test and evaluate for the fresher's. Generate and analyze report
on daily/weekly production, supervising operations and taking critical
decisions with regards to performance. Fine tuning processes. Accountable
for reviewing processes on a regular basis and developing SOP. Responsible
for allocating work to subordinates and ensuring timely completion,
Preparing and generating reports for tracking performance/profitability and
submitting the same to top management on a fortnightly/monthly basis for
review.
Lloyds Medical Solutions Private Ltd, Bangalore (Sep 2010 to May 2011)
Joined as 'Billing Manager' to manage and handle Medical Billing team for
different clients. My primary duty was to train the new comers for billing
process and develop Billing Training Module (manual). E-mail co-ordination
and Teleconference with client for day-to-day process and send the
production report on a Weekly / Monthly basis. Allocate the work
accordingly to the team members and ensue timely completion.
In addition, taking interview for billing team, generate and analyze report
on weekly production, supervising operations and taking critical decisions
with regard to performance. Fine tuning processes. Implementing new
policies and procedures for compliance and ensuring claims are correctly
mailed to insurance carriers, Bringing improvements in processes by
identifying gaps & taking steps to rectify same. Implement and execution of
various quality improvement strategies for continual improvement in process
and TAT's (turn around time). Accountable for reviewing processes on a
regular basis and developing SOP. Preparing and generating reports for
tracking performance/profitability and submitting the same to top
management on a fortnightly/monthly basis for review.
Epi-source India Ltd, Chennai (Nov 2008 to April 2010)
Joined as 'Senior AR' (Assistant Manager) my initial job assignment was to
streamline the Billing process. Handling payments and denial team and
trained the team members in analysis and calling process to clear up AR
backlogs to streamline the process. Maintain TAT (turn around time) for
payment batches. Weekly team meeting and training for the team members.
Update the client specific document and team member's periodically.
During my tenure based on my work performance I was moved to handle AR
team. I was handling two end to end clients. Mail co-ordination and
Teleconference with client for client related issues and clarifications.
Train the new comers for AR analysis and calling process. Co-ordinate with
entry and payment team members for client related updates and issues on a
daily basis. In addition, analysis on patient accounts/claims resulting in
increased collections. Preparing and generating reports for tracking
performance/profitability and submitting the same to top management on a
fortnightly/monthly basis for review.
Gallant Associates, Chennai (April 2006 to Sep 2008)
I moved to Gallant Associates to manage different clients and started as an
'AR Manager'. The job profile involved me to project and report company
revenue from our 'Medical Billing' clients.
My initial job assignment was to streamline the existing collection process
and thereby increase the company's revenue. In addition, generate and
analyze report on weekly production, Account / Team performance. Analysis
on patient accounts/claims resulting in increased collections. Supervising
operations and taking critical decisions with regard to performance. Fine
tuning processes. Implementing new policies and procedures for compliance
and ensuring claims are correctly mailed to insurance carriers, workers
compensation board and attorneys. Defining accountability areas for the
Team. Bringing improvements in processes by identifying gaps & taking steps
to rectify same. Active participation in execution of various quality
improvement strategies for continual improvement in services and TAT's
(Turn Around time). Accountable for reviewing processes on a regular basis
and developing SOP. Responsible for allocating work to subordinates,
ensuring timely completion Preparing and generating reports for tracking
performance/profitability and submitting the same to top management on a
fortnightly/monthly basis for review.
I played a vital role, with other managers, in documenting various business
processes. During this period client trained me in HIPAA compliance and CMS
guidelines pertaining to my clients' specialty.
E-care India Pvt Ltd, Chennai (February 2002 to March 2006)
I started my career in US Healthcare industry as 'Process Executive'. My
primary job was to key in the patient demographics, charge entry and
posting the payment information in the medical billing software.
Then I was promoted as an 'Accounts Receivables' follow-up caller. I had to
call Insurance companies to find the status of claims and patients for
payment related information. During my term I was promoted as Team Leader;
my primary job was to coordinate and execute daily jobs with a team of 20
members and train them. My job profile involved extensive communication
with our clients.
In US Health care - Provider side - BPO (medical billing) I have handled
different Software's (eClinicalWorks, Allscripts, Lytec, GREENWAY, e-
MEDSYS, Medisoft, NextGen, TCMS, etc.,) Specialties (Vascular Surgery,
Radiology, Internal Medicine, Cardiology, Gynecology, ASC, Anesthesia, Pain
Management, Workmen's Compensation and No Fault)
Personal characters:
o Keenness to learn and update knowledge
o Neatness and accuracy in work with attention to details.
o High degree of involvement in fulfilling the task.
o Ability to get along with others and consider other viewpoints.
Personal Details:
o D.O.B : Mar 29th 1980
o Fathers Name : M. Dharuman.
o Languages Known : Tamil, Telugu & English
o Marital status : Married
Place: Chennai.
Yours Truly,
Date: D.
Mohan Raj.
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