Vinit Sushil Shethia

Financial Analyst - Managed Care @Bristol Hospital And Health Care Group, Inc

Bristol, CT, US

Evaluate current charging and coding structures across revenue-generating departments to ensure accurate capture of services, compliance with government and third-party payer regulations, and optimization of reimbursement.Monitor and interpret updates in billing and coding rules (e.g, CMS, CPT/HCPCS, ICD) and proactively communicate actionable insights to relevant clinical and administrative departments.Conduct comprehensive reviews of charge capture mechanisms—including EHR clinical systems, encounter forms, and dictionaries—to identify gaps and ensure data integrity across all patient encounters.Maintain and update the Charge Description Master (CDM), ensuring timely and compliant revisions that align with regulatory and reimbursement updates.Perform in-depth analytics on charging trends, pricing strategy, and charge reconciliation to identify revenue enhancement opportunities and reduce leakage.Analyze payer reimbursement variance trends and collaborate cross-functionally with Contract Management and Revenue Cycle teams to resolve discrepancies and streamline payment workflows.Support leadership with data-driven insights and financial impact analyses for both hospital and professional billing operations.Assist in identifying and implementing process improvements to enhance revenue integrity and financial performance across the organization.

VMV Commerce JMT Arts JJP Science College, Wardhaman Nagar

HSC, Biology/Biological Sciences, General

University of New Haven

Masters, Public Health

Maharashtra State Board of Technical Education (MSBTE)

Diploma, Pharmacy

Bhanuben Nanavati College of Pharmacy - India

Bachelor of Pharmacy - BPharm, Pharmacy