Gnanavel Kumar

US Healthcare Revenue Cycle Management (RCM) and Operations Leader with 13 years of experience managing large-scale healthcare operations, people, and revenue-cycle processes supporting the US healthcare market. Currently managing 120 HC across multiple critical RCM functions, including Demographics, Charge Entry, Clearinghouse Rejections, and Payment Posting, with responsibility for an average monthly volume of approximately 250,000 accounts.

Extensive expertise across the end-to-end US Healthcare RCM lifecycle, including Prior Authorization, Radiology services, charge capture, claims processing, clearinghouse operations, payer processes, payment posting, rejection management, and revenue integrity. Proven ability to manage complex operations while driving productivity, quality, SLA adherence, turnaround time, and financial performance.

Strong track record in process improvement, root-cause analysis, system issue identification, and corrective action implementation. Recognized with an Excellent Detection Award for identifying a billing-system gap related to insurance placement/locator setup for Radiology, impacting 319 accounts with approximately $165K in claim value and contributing to improved clean-claim performance, First Pass Payment Rate (FPPR), and claim-processing efficiency.

Experienced in people leadership, stakeholder management, KPI/SLA governance, quality management, operational risk identification, and continuous improvement, with a strong ability to translate business challenges into scalable and measurable operational solutions.

Core Strengths: US Healthcare RCM | Operations Management | 120 HC Leadership | 165K+ Accounts/Month | Prior Authorization | Radiology RCM | Charge Entry | Clearinghouse Rejections | Payment Posting | Claims Operations | Revenue Integrity | Process Improvement | Root Cause Analysis | KPI/SLA Management | Quality & Compliance | Stakeholder Management