Tapan Kumar

About Tapan Kumar

As a skilled Accounts Receivable, I excel in managing claim status inquiries with payers,…

Experience

1. Revenue Cycle Management Specialist

   Scale Healthcare

   Jan 2024 — Present · Sahibzada Ajit Singh Nagar, IN

   Call payers and use probing questions to understandthe claim status.• Review denied claims on payer portals or EOBs andtake necessary steps to resolve the denial that areoutlined by the client or management.• Clearly document multiple EHR systems to ensureclear understanding of actions taken to resolve theclaim.• Write, submit and follow up on appeals for deniedclaims.• Meet quality and productivity standards set bySignature and/or our client.• Review billing documents as assigned for submissionto insurance plans and government entities(Medicare, Medicaid, Tricare etc). Clearing all editsnecessary for clean claim submission.•Refer all needed claims to proper managementpersonnel when unable to achieve clean claim statusfor submission.• Review and understand EOB\'s/RA\'s (Explanation ofBenefits and Remittance Advice documents receivedfrom insurance payers and government entities.•Process all required payments, adjustments toaccounts when claim payment is received if requiredin client or company systems.• Contact insurance plans and governments entitiesusing online systems, email, and phone to resolveunpaid claims.• Providing data to management on trends found withpayers in claims adjudication process affectingclaims payment.• Provide excellent customer service in keeping withSignature\'s legacy both internal and externally.• Assist with process design and redesign as neededfor Signature\'s client• Maintain expertise in multiple current client systems.• Maintain up to date knowledge of revenue cyclemanagement, industry trends perform other duties asnecessary.• Acts as an effective team Leader.(Resolve Team member queries)(Assign the work to them)(Audit the completed work by them)