Open to opportunities

Aditya Pathak

@adityapathak1

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Experienced professional in Denial Management and Revenue Cycle Management.

India

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What I'm looking for

I am seeking a challenging role in a dynamic environment that fosters growth and innovation.

With over 3.5 years of experience in Denial Management and Revenue Cycle Management (RCM), I am a highly motivated professional dedicated to providing innovative business solutions. My journey has been marked by a commitment to efficiency and continuous learning, allowing me to contribute effectively across various segments of RCM.

Throughout my career, I have honed my skills in professional billing, particularly in managing denied claims for commercial payers. My experience includes working with billing software such as Quick Med Claims and Thrive, where I have successfully resolved disputes and maximized revenue for clients. I am passionate about process improvement and compliance, ensuring that all billing procedures adhere to regulations while maintaining accuracy and efficiency.

Experience

Work history, roles, and key accomplishments

Sr. AR Claims Associates

Pacific BPO Pvt Ltd

Jun 2024 - Present (1 year 1 month)

Worked on the Thrive billing software as an AR for multispecialty denied claims, focusing on Medicare, VA, Medicaid, and Commercial payers. Prioritized higher dollar and high aging claims, with a major focus on authorization and referral denied claims resolution for orthopedic and surgery specialties.

Thrives Multispecialty Denied Claims Medicare VA+Medicaid High Dollar Claims Referral Denials

Quality Analyst

I Services BPO Pvt Ltd

May 2023 - Present (2 years 2 months)

Audited billing records for accuracy and compliance, identifying inefficiencies and recommending process improvements. Trained staff on billing procedures and regulations, ensuring adherence to HIPAA and other relevant regulations.

Auditing Process Improvement Training Data Analysis Compliance HIPAA)Documentation

AR Claims Associates

I Services BPO Pvt Ltd

Oct 2021 - Present (3 years 9 months)

Worked on billing software, Quick Med Claims, and specialized in handling commercial payer's denied claims, particularly BCBS. Followed up on outstanding medical denied claims with insurance companies to resolve disputes and facilitate payments.