Suresh G Email & Phone Number

Chennai, Tamil Nadu, India

• Analyzed medical billing data and insurance claims using SQL and Python, identifying patterns to improve the efficiency of revenue cycle management and reducing claims rejection rates by 15%.• Automated reporting processes by developing data pipelines in Excel and Python, streamlining the preparation of monthly claim submission and follow-up reports, saving over 20% of manual processing time.• Created Power BI dashboards to visualize critical performance metrics such as claim status, payment trends, and accounts receivable, enabling management to make data-driven decisions on billing operations.• Collaborated with cross-functional teams to resolve claim disputes and billing issues, optimizing claim submission workflows and reducing processing time by 10%.• Utilized Jira to track project tasks and ensure accurate data reporting, resulting in improved claim turnaround time and consistent adherence to compliance regulations.

India

• Extracted and analyzed insurance claim data using SQL, identifying trends in claim approvals and rejections, which led to a 12% improvement in payment recovery for healthcare providers.• Automated financial and operational reports using Python and Excel, improving the accuracy of claims submission tracking and reducing reporting errors by 20%.• Developed Power BI dashboards to monitor key metrics like claim aging, payment delays, and denial rates, helping reduce overall claim denial rates by 8%.• Worked closely with the billing team to optimize the revenue cycle process, leading to a reduction in the average claim processing time by 15.• Managed data-driven projects in Jira, ensuring compliance with healthcare billing regulations and improving overall operational efficiency in claims processing.

Chennai, Tamil Nadu

• Extracted and analyzed healthcare billing and insurance claim data using SQL, providing insights into operational bottlenecks and enhancing revenue cycle management efficiency.• Collaborated with the billing and claims team to create detailed reports on claim status, denials, and payment collection, improving the accuracy and speed of billing processes by 10%.• Developed Power BI dashboards for tracking claim performance metrics such as submission success rates, payment timelines, and rejected claims, enabling management to take corrective actions quickly.• Automated audit processes using Python to check claim accuracy and compliance, reducing iscrepancies by 15% and ensuring adherence to healthcare regulations.

Chennai

• Specialties: Oncology, Pain management, physical therapy, General surgery, ophthalmology, pathology & podiatry• Lead the overall efforts of the operational and client service resources within the scope of responsibility. Manage the operational and client service staffing needs based on the growth of Office-Based Billing business unit.• Oversee delivery of optimized collection results for clients• Oversee clinic billing status, payment activity and Accounts Receivable follow up• Monitor call center for efficiency and excellent customer service• Ensure standard workflow and address client specific requirements through coordination of resources.• Troubleshoot and resolve any issues related to monthly closing and report generation/reconciliation process by utilizing good financial practices• Establish budget targets and ensure delivery of revenue and cost goals for areas of responsibility.• Work with Client Service Managers to address client-specific issues.• Manage the operation’s processing team to guide workflow and ensure the processes are understood broadly and are effective in addressing client needs.• Respond to potential workflow and client issues as they surface and develop solutions that are satisfactory to the competing priorities (e.g., client satisfaction and cost).• Mentor Client Service and Operations managers as needed.• Assist with client visits to address operational or workflow requests.• Work collaboratively to acquire new accounts and make sure that the proposed services can be delivered within planned costs.• Advocate for and define requirements for technical changes that will improve business processes and service delivery.• Provide input and sign-off for client budgets to ensure aggressive and realistic targets.• Ensure that high process impact items such as client billing connections are prioritized to minimize any service disruptions or to improve operational efficiencies.

Chennai

• Specialties: Radiology, anesthesia, physical therapy & general practice• Roles: Worked initially on charge & demographic entry, payment posting and account receivable analysis.• Promoted as GC within 1 year and started handling team size of 20• Team co-ordination and training• Client update to the team on regular basis• Co-ordination with quality team for maintenance of client expected quality• Maintain logs for payment & charge• Grievances escalation to higher management

Chennai

• Specialties: Physical therapy, general practice, cardiology & assistance surgeons• Entering Demography & charge for patients• Quality control for charge team• Consolidation of charge clarification

Bachelor Of Computer Applications, Computer Programming, Specific Applications

High School