I am a Senior AR Analyst with four years of experience in US Healthcare Revenue Cycle Management, specializing in accounts receivable, denial management, medical appeals, and out-of-network reimbursement negotiations.
I investigate complex claim denials for commercial and government payers, identify root causes, and prepare Level 1–3 clinical and administrative appeals. My work includes applying payer policies, LCD/NCD guidelines, CARC/RARC analysis, and timely filing requirements.
I have hands-on experience with clearinghouse and healthcare platforms including Availity, Waystar, Change Healthcare, and Epic Release of Information. I use these systems to manage claim workflows, submit medical records, and resolve authorization and medical-necessity denials.
I am experienced in aging analysis, cash posting, credit balance resolution, unapplied cash reconciliation, and reducing aged AR. I have contributed to substantial revenue recovery and improved claim acceptance and appeal approval rates.
I also specialize in No Surprises Act open negotiations, Qualifying Payment Amount benchmarking, and Independent Dispute Resolution filings. I am committed to HIPAA compliance, maximizing reimbursement, and continuously developing my healthcare revenue cycle knowledge.
Analyzes and resolves complex insurance claim denials for commercial payers including BCBS, Aetna, and UHC, as well as government payers including Medicare and Medicaid.
Investigates denial root causes, files Level 1–3 appeals, and applies LCD/NCD guidelines. Recovered more than $1.2M in outstanding revenue and reduced claim rejection rates by 18% over 12 months.
Streamlined submission of clinical appeal packages and medical records across Availity, Change Healthcare, and Epic Release of Information workflows.
Managed medical-necessity and authorization denials, achieving a 68% first-level appeal approval rate and recovering more than $850K in improperly denied revenue.
Used Qualifying Payment Amount benchmarks and geographic market data to develop payment counteroffers during out-of-network open negotiations.
Increased average claim reimbursement by 35% and recovered more than $450K in underpaid out-of-network revenue.
B.Com, Commerce
Bachelor of Commerce with 65%.
Higher Secondary
Completed higher secondary education with 74%.
Secondary School
Completed secondary education with 68.8%.
This professional hasn’t added portfolio projects yet.
This professional hasn’t listed any services yet.
