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Dhanesh Sukumaran

@dhaneshsukumaran

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Quality Assurance Analyst specializing in accurate medical billing claims, denials, and audit reporting.

India

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What I'm looking for

I’m looking for a Quality Assurance role where I can own audit quality, strengthen denial and claim workflows, and improve performance through clear reporting, documentation, and feedback—working with teams that value accuracy, accountability, and continuous process improvement.

I’m a Quality Assurance Analyst and medical billing professional with over 6 years of experience in in-patient, out-patient, physician medical billing. I focus on filling accurate claims, adjusting rejected claims, and understanding insurance contracts, appeals, and EOB.

In my QA work, I audited AR follow-up calls and evaluated claim resolution accuracy, analyzed denied claims, and verified appropriate actions for resubmission/appeals. I also monitored seaman aging reports, ensured timely follow-ups, and identified trends in denials to drive process improvements.

Across billing and revenue cycle activities, I call insurance companies for unpaid or denied claims, check claim status (paid/pending/denied), correct errors, and submit appeals with proper documentation. I verify payment postings and identify underpayments or overpayments to reduce recurring mistakes.

Right now, I’m maintaining and updating process-specific audit files, reporting progress and audit status, and tracking quality scores. I provide structured feedback to improve team performance while using KRA/KPI tracking, documentation & audit reporting, MS Excel, and tools like Python/Java in my workflow.

Experience

Work history, roles, and key accomplishments

Current

QA Analyst

Current

VohraWound Care Pvt. Ltd.

Jan 2024 - Present (2 years 2 months)

Maintained and updated process and audit files, ensuring submissions were completed within TAT and reworks were achieved. Reported audit progress and quality status to QAL, updated audit numbers for KRA, and provided structured feedback to improve team performance.

Auditing Audit Reporting TAT Management Call Quality Monitoring Structured Feedback

QA Analyst

Paddle Point BPO Services Pvt. Ltd.

Jan 2022 - Jan 2024 (2 years)

Audited AR follow-up calls and evaluated claim resolution accuracy for resubmissions and appeals. Analyzed denied claims, verified payment postings, identified denial trends, and produced daily/weekly/monthly QA reports.

Medical Billing A R Follow Up Appeals EOB Review Auditing Process Improvement Audit Reporting

Senior Account Receivable

Credence Resource

Mar 2021 - Dec 2021 (9 months)

Called insurance companies to resolve unpaid or denied claims and checked claim status (paid/pending/denied). Worked denied claims to correct errors, submitted appeals with documentation, and tracked denial trends to reduce future errors.

Medical Billing Insurance Verification Denial Management Appeals Documentation Trend Analysis

AR Associate Trainee

Gebbs Healthcare Solutions

Oct 2018 - Sep 2019 (11 months)

Checked claim status (paid/pending/denied) and corrected denied-claim errors to support accurate billing. Submitted appeals with proper documentation and tracked denial trends to reduce repeat issues.

Medical Billing Denial Management Appeals Insurance Verification Trend Analysis