abhijith jayakumar
@abhijithjayakumar
US physician claims denial and credit balance analyst specializing in RCM resolution.
IndiaWhat I'm looking for
I’m a Claims Denial Analyst & Claims Credit Balance Specialist with strong experience in US Physician Claims (RCM). I review, research, and analyze denied physician claims to identify claim-level and payer-level issues, then resolve denials across eligibility, coding, modifiers, bundling, medical necessity, COB, and timely filing.
I also research and correct claims credit balances by handling overpayments, duplicate payments, and incorrect postings, including payer correspondence, multi-state recovery letters, and disputes with supporting claim documentation. At Guidehouse India, I perform daily payer portal status checks, improve first-pass claim acceptance, collaborate with coding and billing teams to prevent recurring denials, and maintain accurate notes while achieving strong performance targets.
Experience
Work history, roles, and key accomplishments
Claims Denial & Credit Balance
Guidehouse India
Dec 2023 - Present (2 years 4 months)
Reviewed and resolved US physician claim denials by eligibility, coding/modifiers, bundling, medical necessity, COB, and timely filing to improve first-pass acceptance and reduce AR. Managed high-volume credit balances by interpreting EOBs/ERAs, payer policies, and overpayment scenarios to drive accurate reimbursements; received Guidehouse GEM Award (2024) and Best Performer (Oct 2025).
Testing & Commissioning Engineer
Alind Relays Limited
Apr 2019 - Apr 2023 (4 years)
Performed testing and calibration of numerical relays and relay testing systems, including factory acceptance testing for railways and electricity boards. Conducted troubleshooting and site commissioning of control and relay panels, using testing kits and documenting results through protection-graph plotting and relay configuration.
Education
Degrees, certifications, and relevant coursework
Cochin University of Science and Technology
Bachelor of Technology, Electrical and Electronics Engineering
2023 -
Grade: 6.87 CGPA
Pursuing a B.Tech in Electrical and Electronics Engineering at Cochin University of Science and Technology since Dec 2023 (CGPA 6.87).
Availability
Location
IndiaAuthorized to work in
Job categories
Skills
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