Healthcare AR and RCM services professional
Resume:
Certified ScrumMaster and versatile Manager with extensive experience in Transitions, Operations, and Project Management, specializing in healthcare Revenue Cycle Management (RCM) projects. Proven leader adept at problem-solving, team-building, and communication, ensuring successful project outcomes through strategic prioritization and effective collaboration.
Certifications:
• Certified Scrum Master (CSM) Workshop by Skill Nation – Chat GPT and AI Tools
• PMP (PMBOK) Trained Certificate by IBM– Introduction to Project Management
• Lean and Six Sigma Greenbelt
• Certificate by Coursera -Business Analysis & Process Management
• Certificate by Solutions3x - Process Trainer
(An AAPC approved Training Facility)
Education:
Master of Business Administration (MBA) Year - 2012 to 2014 Human Resource Management, XIBMS - Xaviers Institute of Business Management Studies. Bachelor of Science (BSc) Year – 1998 to 2001
Computer Sciences, St Francis Degree College.
Skills:
Methodologies: Waterfall, Agile, Scrum,
Applications: Jira, Salesforce, MRM, EPIC
Technical: C, MS Office, Google Suit
Business Skills: People Management, Business Process Analysis and Data interpretation, Change Management Process Transition, Effective Communication, Employee Relations, Attention to detail, Adaptive. Professional Experience
Solutions3x Pvt Ltd
Operations Manager – Revenue Cycle Management services April 2022 – Until present
1. Operations and Training Management
• Orchestrated end-to-end projects within Healthcare Revenue Cycle Management, encompassing Patient access, Benefit Verification, Authorization, Billing, Cash Posting, AR Follow-up, Denial Management, and Appeals, pivotal in driving the company's initial success and subsequent growth.
• Devised proactive client engagement strategies, culminating in a substantial 15% augmentation in client satisfaction and repeat business. Strategized project plans in alignment with client objectives, meticulously documenting project progress, analyzing data and reporting.
• Spearheaded the development of tailored, engaging training content, fostering the seamless integration of candidates into client operations through comprehensive healthcare billing and coding training sessions, thereby enhancing certification exam success rates.
2. HR Management:
• Streamlined recruitment, training, and placement processes, reducing onboarding time for new recruits to three months per batch and enhancing the overall onboarding experience by 20%.
• Proactively involved in developing company policies and procedures, ensuring strict compliance with guidelines related to HIPAA, and PHI.
Optum Global Solutions Pvt Ltd
Assistant Manager – Medical Coding
November 2019 – March 2022
Harini Chetlapalli
Scrum Master & Operations Manager
******.***********@*****.***
Frisco, Texas
https://www.linkedin.com/in/harini-chetlapalli-44a7b9179/ 1. Operations and Quality Management:
• Directed time-sensitive projects within Optum Global Solutions' HCC Coding process, consistently achieving exemplary quality and productivity targets. Worked with cross functional teams to maintain compliance requirements of the project through regular audits, implementation of policies, training and reporting.
• Led an automation project aimed at screening Medical records and coding HCC diagnosis codes for retro billing, with responsibilities spanning planning, implementation, and auditing, data Analyses and reporting.
• Managed a team of 35 to 40 Medical coders, surpassing quality and productivity targets, resulting in a notable 10% enhancement in coding accuracy.
• Acknowledged with Manager Excellence awards in R&Rs for outstanding performance in 2020 and 2021. 2. Management Training and Team Development:
• Conducted impactful management training programs for newly appointed Management trainees, fostering effective team development.
• Implemented management training initiatives, contributing to a significant 15% increase in team efficiency and productivity.
3. Performance Measurement and Project Coordination:
• Implemented performance measurement tools and techniques, facilitating objective team appraisals and performance improvements.
• Coordinated project activities, including meetings, planning, resource allocation, quality control, data analysis, and reporting, ensuring consistently effective project performance. Consultant – Small Business - Backend Support
HR Consultant
July 2017 – December 2021
1. Payroll Process Management and Administrative backend support
• Achieved 100% accuracy in weekly and biweekly payroll processing, effectively managing IRS and state tax filings.
• Optimized bookkeeping and data management processes, enhancing client satisfaction.
• Produced detailed monthly financial reports, offering transparent insights into business performance to facilitate strategic decision-making.
2. Digital Marketing and Sales Strategies:
• Designed websites using platforms like Wix, employing strategic and user-centric approaches to improve online presence and accessibility.
• Implemented impactful digital marketing strategies, resulting in a 20% increase in online visibility and engagement. Conducted regular website audits to ensure optimal functionality, responsiveness, and user experience.
Founding Years & Learning Centers Pvt Ltd
Centre Director
May 2018 – October 2019
1. Administration and Branch Management
• Monitored performance, evaluated efficiency, and ensured the effectiveness of preschool activities, employing forecasting, strategy planning, and proactive problem prevention.
• Managed administrative duties, resulting in a 20% reduction in operational costs through meticulous budgeting and efficient financial accounting.
• Implemented employee engagement initiatives, leading to a notable 15% improvement in employee satisfaction and retention.
2. Marketing and Admissions:
• Arranged and hosted impactful campaigns, events, and exhibitions, contributing to a remarkable 25% increase in student admissions and heightened parent satisfaction.
• Managed corporate and individual parents' tours, fostering positive relationships and enhancing the overall admission experience.
3. Salesforce Utilization:
• Leveraged Salesforce for sales management and data analysis, resulting in a 10% increase in lead conversion rates, showcasing proficiency in technology-driven business enhancement. Genpact
Team Lead – Accounts Receivables – RCM Services
Jun 2012 – March 2016
1. Project Management and Project Transitions:
• Orchestrated the seamless transition of a critical client, Walgreens, from Tier 1 to Tier 4 operations, ensuring zero disruptions to daily activities.
• Played an integral role in shareholder communication and contributed to the development and implementation of Standard Operating Procedures (SOPs), Process Maps, and transition strategies for projects.
• Provided comprehensive training in Pharmacy (Rx) Billing, Accounts, and denial management services to ensure team readiness for project transitions.
• Effectively managed project milestones and deadlines, ensuring tasks were completed within specified parameters to meet Key Performance Indicators (KPIs) and Critical to Quality (CTQ) requirements. 2. Recognition and Promotion:
• Earned a promotion to Team Lead via an internal job posting (IJP), acknowledging sustained excellence in performance.
• Recognized with the Best Employee award during R&R and Genpact Client Awards for three consecutive years (2013, 2014, and 2015), underscoring consistent and exceptional contributions. 3. Lean Six Sigma Expertise:
• Certified in Lean Six Sigma Greenbelt and proficiently applied Lean Six Sigma methodologies, resulting in a notable 15% reduction in the time and effort required for the Revenue Cycle Management (RCM) process. Anthelio Business Technologies Pvt Ltd (ATOS)
Senior Process Developer – Accounts Receivables – RCM Services February 2011 – May 2012
1. Project Management and Compliance:
• Managed Accounts Receivables projects specializing in Hospital billing and denial management within a BPO environment, handling time-sensitive billing processes for diverse insurances including Medicare, Commercials, Managed Care, No Fault, and Workers Compensation.
• Demonstrated versatility and adaptability in Provider Billing, particularly in Critical Access Hospitals (CAH), showcasing proficiency in team collaboration, problem-solving, and communication.
• Conducted training sessions on HIPAA awareness and assisted in ISO internal audits, ensuring the implementation of regulatory requirements for privacy and security across branch operations. 2. Mentorship and LEAN Six Sigma Initiatives:
• Mentored new team members, facilitating their professional growth within the organization.
• Led and executed two LEAN Six Sigma projects focused on process development, resulting in a noteworthy 10% reduction in errors and a 20% increase in project efficiency Apollo Health Street Pvt Ltd
Process Associate – RCM Services
November 2009 – February 2011
1. Operations:
• Managed Provider Revenue Cycle Management Projects, consistently meeting Key Performance Indicators
(KPIs) and Critical to Quality (CTQ) requirements.
• Excelled in commercial insurance billing, benefits, and authorization verification, leading to a commendable 15% reduction in claim rejections.
• Implemented streamlined payment posting procedures, resulting in a significant 10% increase in revenue collection.
2. Lean Six Sigma Project Leadership:
• Spearheaded a successful Lean Six Sigma project aimed at enhancing the quality and efficiency of the RCM process
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