Swaroop Karpe

About Swaroop Karpe

Hello Recruiters! I\'m a Highly skilled and dedicated medical billing professional with 4+ years of experience as a Senior Account Receivable. I possess a deep understanding of the intricacies of the medical billing process and a proven track record of maximizing revenue and resolving complex claim denials. My expertise lies in effectively communicating with insurance representatives, analyzing denial scenarios, and implementing strategic appeals to ensure optimal reimbursement. I am adept at leveraging medical billing software and staying updated with the latest industry trends and regulatory changes to ensure compliance with HIPAA and PHI regulations. Throughout my career, I have successfully managed a high volume & high dollar claims, reducing outstanding accounts receivable and driving financial success for healthcare organizations. As a passionate and dedicated professional, I am eager to contribute my expertise, drive revenue optimization, and ensure seamless operations within the medical billing industry. I am excited to connect with fellow professionals, explore collaborative opportunities, and make a positive impact in the field of medical billing.

Experience

1. Senior Analyst Ar

   Viewgol

   Mar 2023 — Present · Mumbai, IN

   Seeking an accomplished Medical Billing and Revenue Specialist with a strong track record in maximizing reimbursements and optimizing revenue using cutting-edge software solutions. • With 4+ years of experience as a Senior Account Receivable, I bring expertise in handling claims, resolving denials, Notes and driving financial success for healthcare organizations. My remote position perfectly aligns with my skills and experience. • My responsibilities are to efficiently manage the end-to-end medical billing process for HCA scope (Form - CMS1500 & Higher Dollar Claims), leveraging advanced software solutions such as One Source (Eligibility & Benefits), Onbase (EOB/ERA), Change Healthcare(Clearing House), AR Collaboration Tool (Credentials / NPI / Taxonomy) and Availity Portals (insurance websites and log in) to ensure accurate claim submissions and timely reimbursements. • Collaborate with insurance representatives and navigate payer websites to track claim status, address discrepancies, and expedite payment processing. Employ strategic appeal processes using software like E-Clinical (ECW 11) and Artiva software to overturn denials, minimize revenue loss, and optimize reimbursement rates. • Utilize expertise in medical coding guidelines and proficiency in various software systems to ensure compliance, enhance claim accuracy, and streamline workflows. • Analyze revenue cycle metrics using software-driven insights to identify process inefficiencies and implement targeted improvements, resulting in increased efficiency and financial performance.

Education

• University of Mumbai

  Bachelor of Commerce - BCom, Accounting and Finance, 'B' Grade

  2015 — 2018