Richard Sakthivel

Resolve complex, high-value claims through in-depth research and effective negotiation. Investigate and appeal denied claims to secure accurate reimbursements. Communicate effectively with patients to resolve billing issues and enhance satisfaction. Conduct root-cause analysis on denied claims, identifying and resolving their underlying issues. Develop and implement denial prevention strategies, achieving a 50% reduction in denied claims. Collaborate with cross-functional teams to optimize revenue cycle processes and improve overall financial performance. Build and maintain relationships with insurance companies to resolve disputes and ensure timely reimbursements. Identify trends in claim denials and implement corrective measures.

Reviewed and monitored accounts receivable aging reports to identify outstanding invoices and overdue payments. Followed up on outstanding claims, resolved billing discrepancies, and identified reasons for denials. Prepared and presented AR reports, aging analyses, and collection status updates to management. Engaged with claims and insurance companies to resolve claim issues and streamline processes. Managed medical claims processing, authorizations, and verifications. Provided training and support to new staff as a floor assistant.

Assisted in patient scheduling and coordinated OTC distribution processes. Experienced in patient scheduling and appointment coordination, ensuring efficient healthcare access and reducing wait times through streamlined processes. Skilled in managing doctor availability and optimizing scheduling for improved patient experience.

AR calling follows up on unpaid claims; denial management fixes rejections for better reimbursement. Made outbound calls to patients, insurance companies, and healthcare providers to resolve outstanding balances and claim issues.