Medical Coding Operations & RCM Leader

SUKALYAN BHATTACHARYYA

***, ** ****** ****, ************* Ph: +91-984*******

Bangalore 560 035 E-mail: *********@*****.***

OPERATIONS MANAGEMENT PROFESSIONAL

Offering a rewarding & successful experience of 20+ years across the industry; seeking senior portfolio in Medical Coding operations/ US healthcare across BPO (Non-Voice), KPO and in ITES sector.

Competent and versatile Professional offering performance driven exposure of managing the entire gamut of activities involved in US Health care/BPO/KPO Industry handling operations. I was handling payer/provider Medical Coding project for US Healthcare in Emids Technologies, Bangalore. Currently, I am working on ED Profee/facility and E/M project with a team of around 60+ and managing the team.

Core functional Competencies

Medical Coding Operations Operational Leadership resulting in revenue enhancement

Customer relationship and satisfaction Project Planning and Development

Team building and retention Revenue Cycle Management

Process Implementation Training & Development

Customer/Contact center operations Software Project Management

Career History

Operations Manager, DeliverHealth, Bangalore Jan 2024 – April 2025

Medical Coding, Client Management & Operations

-Specialties Handled: Emergency Department both Profee & Facility, E/M, Outpatient

-Client management: Regular interactions over call, weekly status update & on various update

-60+ certified medical coders

-Client onboarding with ramping up the team. Built the team from scratch in this Org

-Bi-weekly team meeting with auditor to understand RCA of errors and boost confidence of coders

-Weekly dashboard Presentation for stakeholders

-Identify top 10% of the production member and monthly reward. Also help out the bottom10% with refresher training.

Project Manager, Emids Technologies, Bangalore Feb 2017 – Jul 2023

Client Management & Operations

Key Responsibilities:

-Client management: Regular interactions over call, daily status update & on various code-based issues as well as insurance for clarifications

-Managing a team of 200+ handling a chain of Clinics for Medical Coding and RCM

-Also working with a software team of 70+ members on migration from Legacy to Cloud.

-Creating weekly MI dashboard Presentation for top management in India and USA

-Part of internal scrubbing PHP-based software which involves both LCD & NCCI edits.

-Problem-solving: Resolve any issues or disputes regarding coding and billing. This may involve working closely with healthcare providers and insurance companies.

-Keeping Updated: Stay updated with the latest changes in the coding rules, regulations, and practices in the U.S. healthcare system.

-Performance Evaluation: Regularly evaluate the performance of the coding team and provide constructive feedback for improvements.

-Quality Assurance: Implement and enforce quality assurance measures, including regular audits, to ensure accurate and compliant coding and billing practices.

Key Achievements:

-Best team award 2023 for my software team.

CODING HEAD – RCM Division, Netmark Business Solutions. Chennai Aug 2014 – Feb 2017

(Consultant)

Key Responsibilities:

-Revenue Cycle Management: Play a crucial role in managing the revenue cycle, which includes patient registration, insurance verification, coding, billing, and claims processing.

-Instrumental in developing SOP’s for the entire process from Independently designed & developed the operations management system

-Working for various clients on RCM on Quality parameters & medical coding- based projects

-Medicare Fraud and Abuse: Prevention, Detection, and Reporting (Developed May 2012, Revised November 2014) training completion

-Handling attrition and measures to control attrition.

-Resource planning, allocation Training of team.

-Creating a weekly Quality presentation for client & onsite team

AVP – Medical Coding Division, Indian Healthcare Services, Chennai Feb 2014 – Jul 2014

Key Responsibilities:

-Specialties Handled: Pathology, Emergency Department, Outpatient & Short-stay surgery, Radiology & IVR, and multispecialty clients including Cardiology, Orthopedic, and Pain Management etc.

-Strategic Planning: Develop and implement strategic plans and objectives for the Medical Coding and RCM department to align with the company’s overall goals and objectives.

-Team Management: Oversee and managing a team of 530 odd members including coding managers, TLs, & medical coders, ensuring their productivity, performance, and adherence to quality standards.

-Client Relationship Management: Was maintaining strong relationships with multiple clients, understanding their requirements, addressing concerns, and ensuring client satisfaction.

-Financial Management: Collaborate with the finance department to develop and manage budgets, monitor expenses, and contribute to revenue generation and profitability.

-The team handles volume of up to 197,000 ED charts, 4,50,000 radiology charts, 75,000 multispecialty charts per month. The internal QC team with direct reporting was covering 11% of total volume.

-Instrumental in developing SOP’s for the entire process from independently designed & developed the operations management systems for seamless operations of the organization.

-Abide the Risk and compliance and improve the customer satisfaction.

-Oversaw contracts with existing clients and agents.

Senior Consultant – RCM & Medical Coding Training, AMRA, Chennai Jan 2010 – Dec 2013

Key Responsibilities:

-Entrusted with timely resolution of all customer conflicts and billing claims. Making the procedure easy for the patients and clients for payments. Responding to the specific calls of clients and acting on the complaints.

-Led project management and infrastructure allocation, technology management and consulting initiatives.

-Evaluating the medical accounts and maintaining the record. Preparing bills of the clients and patients and keeping its record. Mapping training needs, imparting training to the employees and recruiting the able staff.

-Conducting business needs analysis, developing customized solutions, and delivery management.

-Accountable for generating proposals and program schedules outlining benchmarks/milestones, resources and deliverables.

Operations Manager – Medical Coding, AVT Infotech Private Ltd., Chennai Aug 2004 – Jul 2009

Key Responsibilities:

-Performance Analysis and Reporting: Analyze coding and billing performance metrics, generate reports, and provide insights to senior management regarding revenue cycle performance, areas of improvement.

-Process Improvement: Continuously identify and implement process improvements to enhance efficiency, accuracy, and revenue optimization, leveraging technology and automation where applicable.

-Training and Development: Provide training, guidance and helped to create internal training team for fresher as well as refresh course.

-The team was handling live coding as well as denial-based coding from both Medicare/Medicaid as well as commercial insurances.

Key Achievements:

-Clean claim submission increased to 95% from the existing 80% resulting collection improvement from $6.5 M to $7.7 M

-Attrition rate reduced to 2% for continuous 3 consecutive years

-Overseeing medical transcription department too.

Executive Associate (Medical Coding), HealthOffice India Private Ltd, Bangalore Oct 2002 – Sep 2004

-Certified by AAPC as one of the top scorers in Hospital Outpatient Coding pioneered in India

-Trained 30+ employees. Actively assisted clients in maximizing our resource utilization.

-Worked with GI, Ortho & Cardiac Surgery chart and was trained by US Coders initially.

-In charge of creating & implementing action plans for efficient utilization of resources and enhanced productivity and quality.

Medical Transcriptionist, Healthscribe India Private Ltd., Bangalore Jun 2000 – Jul 2002

-Part of team of a large hospital group in Oregon.

-Assisted in creation and implementation of new systems for effective utilization of resources and optimizing productivity.

-Supported the team to meet the client goals.

ACADEMIC CREDENTIALS AND PROFESSIONAL DEVELOPMENT

Bachelor of Pharmacy, Bangalore University, 1998

Bachelor of Science (Zoology), Calcutta University, 1993

CERTIFICATIONS:

SS&C Blue Prism Robotic Process Automation Professional Certificate, 2023

Leveraging Generative AI for Project Management, 2023

Certified Scrum Master from Scrum Alliance, 2019

Six Sigma Green Belt from ISI (New Delhi), 2005

Certified Outpatient Coder (COC) from AAPC. Membership ID: 00085992, 2002

ADDITIONAL INFORMATION

Ph: 984*******

References: Available on Request

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