BHUVANESHWARAN M
Sanatorium
Summary
Highly experienced and detail-oriented medical billing and AR professional And Credit balance with a proven track record of maximizing revenue and minimizing denials, seeking a challenging role to leverage expertise in [ Epic, Nexgen, Net health] and contribute to a successful revenue cycle.
Overview
3
3
years of professional experience
Work History
Prior Authorization AR Specialist
ACCESS Healthcare Services
04.2025 - 11.2025
- Collaborated with healthcare providers to obtain timely prior authorizations, ensuring patient access to necessary treatments and services.
- Reviewed and analyzed patient medical records to determine eligibility for insurance coverage, enhancing approval rates and patient care continuity.
- Implemented a systematic approach to track authorization requests, reducing processing time and improving workflow efficiency.
- Communicated effectively with patients to explain coverage criteria and authorization processes, ensuring clarity and compliance with insurance policies.
- Trained new staff on prior authorization procedures and documentation standards, fostering a knowledgeable team and promoting operational excellence.
- Monitored and updated authorization status in electronic health record systems, maintaining accurate records for audits and compliance checks.
Credit balance AR
OMEGA HEALTH CARE PRIVATE LIMITED
04.2024 - 03.2025
- Regularly review patient accounts for credit balances, overpayments, and potential refund situations.
- 1. Investigate the root cause of credit balances, including overpayments, insurance adjustments, or errors in billing.
- Initiate and process patient and insurance refunds in accordance with established procedures and payer requirements.
- 2. Make necessary adjustments to patient accounts to reflect credit balances or overpayments.
- 3. Document all research, investigations, and resolutions related to credit balances in the patient & Insurance management system.
- Ensure accurate and timely posting of adjustments and refunds to Insurance& patient.
- 4. Communicate effectively with insurance companies, and other stakeholders to resolve billing issues.
- 5. Maintain accurate records and documentation of all activities related to credit balances and AR management.
Credit balance analysis
AGS HEALTH CARE PRIVATE LIMITED
08.2022 - 02.2024
- Regularly review patient accounts for credit balances, overpayments, and potential refund situations.
- 1. Investigate the root cause of credit balances, including overpayments, insurance adjustments, or errors in billing.
- Initiate and process patient and insurance refunds in accordance with established procedures and payer requirements.
- 2. Make necessary adjustments to patient accounts to reflect credit balances or overpayments.
- 3. Document all research, investigations, and resolutions related to credit balances in the patient & Insurance management system.
- Ensure accurate and timely posting of adjustments and refunds to Insurance& patient
- 4. Adhere to all applicable billing guidelines, payer requirements, and regulatory standards.
- 5. Maintain a high level of accuracy in all billing and refund processes.
Education
BA - Economics
SIVET College
01.2022
Skills
- Language: English, Tamil
Prior authorization
Patient eligibility
Insurance coverage
Workflow efficiency
Client communication
EHR systems
Credit balance analysis
Refund processing
Billing adjustments
Account reconciliation
Claims resolution
Insurance management systems
Interests
I like Video, music, Traveling, party
Timeline
Prior Authorization AR Specialist
ACCESS Healthcare Services
04.2025 - 11.2025
Credit balance AR
OMEGA HEALTH CARE PRIVATE LIMITED
04.2024 - 03.2025
Credit balance analysis
AGS HEALTH CARE PRIVATE LIMITED
08.2022 - 02.2024
BA - Economics
SIVET College