Rohi A

Manager of Revenue Cycle Operations

Medi Care • Período integral

Feb 2023 - Jan 2026 • 2 yrs 11 mos

As a Medicare Billing Manager, I specialized in the end-to-end management of Part A and Part B claims, ensuring strict adherence to CMS (Centers for Medicare & Medicaid Services) guidelines. I led a dedicated team to streamline the submission process, drastically reducing the Medicare denial rate through proactive claim scrubbing and eligibility verification. My responsibilities included expertly handling Redeterminations, Reconsiderations, and the entire Medicare appeals process in order to recover stuck revenue. I was responsible for monitoring 'LCD' and 'NCD' policy updates to ensure coding compliance and maximize reimbursements. By implementing efficient workflow strategies, I successfully optimized the revenue cycle for federal programs, ensuring consistent cash flow and 100% audit readiness for my providers.

Senior Medical Billing Speicalist / Quality Assurance Lead

MTBC (CareCloud) • Período integral

Jan 2018 - Feb 2023 • 5 yrs 1 mo

During my impactful five-year tenure at MTBC, I specialized in end-to-end Revenue Cycle Management (RCM) for diverse U.S.-based medical practices. I was responsible for ensuring the highest level of accuracy in claim scrubbing, submission, and payment posting. My role evolved into performing deep-dive Quality Assurance (QA) audits to identify coding errors and prevent denials before they occurred. I worked extensively on reducing Days in AR by implementing aggressive follow-up strategies with major insurance carriers and resolving complex billing discrepancies. This role solidified my expertise in HIPAA regulations and high-volume billing operations, ensuring consistent financial growth for my assigned providers.

Collections Manager / Medical Billing Expert

Medical Lien Management • Período integral

Aug 2012 - Jan 2018 • 5 yrs 5 mos

Spanning a dedicated six-year tenure at Medical Lien Management (2012–2018), I established a robust foundation in the U.S. Healthcare sector, specifically focusing on full-cycle Medical Billing and Revenue Cycle Management (RCM). My career progressed from auditing complex financial claims to leading high-performance teams as a Collections Manager, where I specialized in U.S. Workers’ Compensation regulations and California-based healthcare billing. I conducted rigorous audits of medical claims, vouchers, and Explanations of Benefits (EOBs) to identify and capture recovery opportunities. As a Floor Trainer and Team Lead, I was responsible for mentoring staff on industry-standard billing processes, managing aggressive AR recovery strategies, and ensuring 100% HIPAA compliance. By leveraging data-driven investigations and strategic denial management, I consistently exceeded revenue targets and optimized the financial health for various medical providers and clinics.