Nanda Kumar

RCM SME / Acting Team Lead

Cognizant • Período integral

Sep 2022 - Apr 2025 • 2 yrs 7 mos

I am a US Healthcare RCM professional with 8+ years of experience, primarily in payer-side operations, with strong expertise in claims adjudication, AR follow-up, denial management, appeals, payment activities, overpayment recovery and revenue recovery. I have strong working knowledge of HMO, PPO and POS claims, including claim review and adjudication, payer guidelines, provider appeals, underpayment and overpayment handling, overpayment setup and recovery, and payment posting activities. In my previous role, I handled AR and denial management, supported revenue recovery, performed root cause analysis, and worked on process improvement initiatives. I managed a team of 17 associates, monitored KPI and SLA performance, and trained and mentored 50+ associates. My experience includes reducing denials by 20–30% and contributing to $500K+ in revenue recovery through AR follow-up and appeals. I can support clients with: • Healthcare claims analysis and review • AR follow-up and aging analysis • Denial management and appeals support • Payment and overpayment-related activities • Claims adjudication support • RCM process analysis and reporting • RCA and process improvement I am detail-oriented, reliable and committed to accurate, timely and high-quality work.