Rahul Y.

About Rahul Y.

Medical Billing Specialist with 6 + years of experience in Revenue Cycle Management, specializing in US Medical Billing for DME, Physician, Mental Health, and Hospital Billing. Experienced in managing end-to- nd US healthcare operations offshore, with a strong background in operational management, project management, business improvements and RPA Implementation. Proficient in leading and overseeing end-to-end RCM operations including intakes, eligibility and benefits verification, pre/post authorizations, claims billing, denial management, payment posting, revenue cycle optimization, and client relationship oversight. Proven expertise in leading and developing teams to uncover hidden revenue by identifying process gaps, coding errors, and denial trends while implementing stronger workflows to elevate overall RCM performance. Skilled in managing small-medium-large teams to drive measurable revenue improvement, operational efficiency, and consistent production quality.

Experience

1. Team Lead

   Carezyn

   Nov 2024 — Present · Jaipur, IN

   Manage the end-to-end Revenue Cycle Management (RCM) process for U.S-based healthcare providers, ensuring seamless and timely reimbursement. My responsibilities cover the entire cycle, including: · KPI Reporting, Dashboards and Direct Client Interaction for improved transparency. · Resolve escalated issues from clients, providers, or internal departments with strategic problem-solving. · Review and optimize team KPIs such as AR days, clean claim rate, denial rate, and collection efficiency. · Oversee onboarding of new providers, ensuring smooth integration into billing workflow. · Facilitate regular team meetings to discuss updates, challenges, and action plans. · Handle workforce planning, shift management, and resource allocation during peak workloads. · Support recruitment by interviewing and evaluating new RCM team members. · Lead, mentor, and train a team of RCM analysts to ensure high performance and process accuracy. · Monitor daily workflow, allocate tasks, and ensure timely completion of billing and follow-up activities. · Conduct quality audits on claims, documentation, and AR follow-ups to maintain compliance and reduce errors. · HIPAA-Compliant Operations, safeguarding provider and patient confidentiality. · Credentialing & contracting with payers to secure smooth payment flow.Practice Management System (PMS): Athena, Office Ally, ModMed, Kareo, zhealthehr, Simple Practice, Vericle(Clinic Mind), Dr Chrono. Interaction with Multiple Insurance Payers: Medicare, Medicaid, BCBS, AETNA, HUMANA, UHC, UMR, CIGNA & Many more other Commercial Insurances in all US States.

Education

• Dev Bhoomi Institute Of Technology

  Bachelor of Science - BS, Science

  2016