Open to opportunities

M M

@mm09

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Quality analyst with healthcare RCM expertise and strong audit and process-improvement skills.

India

Message

What I'm looking for

I seek a role in healthcare RCM or quality assurance where I can improve claim accuracy, implement SOPs, mentor teams, and deliver measurable process improvements while meeting SLAs.

I am a detail-oriented Quality Analyst with extensive experience in healthcare revenue cycle management, claim audits, and process improvement across multiple organizations. I have worked with tools such as CAS 2, EPIC, and Cerner to perform claim quality checks, prepare audit metrics, and deliver actionable findings to leadership.

I consistently drive improvements by developing SOPs, conducting calibration sessions, mentoring team members, and managing daily workloads to meet SLAs and TATs. My background includes handling claim rejections and denials, stakeholder communication, and producing clear reports that highlight trends and recommended actions.

Experience

Work history, roles, and key accomplishments

Current

Quality Analyst

Current

Kroll Settlement Administration

Apr 2025 - Present (6 months)

Perform quality checks on class action lawsuit claims using CAS 2, conduct detailed analysis of claim data and processes, and prepare reports with recommended improvements to ensure SOP compliance.

CAS Quality Assurance Audit Reporting Data Entry Process Improvement

Quality Analyst

Guidehouse

May 2021 - Oct 2023 (2 years 5 months)

Led QA for dental billing using EPIC, performed claim audits against client SOPs, produced daily/weekly/monthly audit metrics, and presented findings and improvement plans to leadership.

Epic Audit SOP Development Data Analysis SLA Management

Sr Associate, Facility

Gebbs Healthcare Solutions

Apr 2019 - Sep 2020 (1 year 5 months)

Processed hospital billing using Cerner, resolved denials and discrepancies with payers, reconciled EOBs/remittance advice, and supported coding/billing accuracy and process improvements.

Cerner Denial Management EOB Reconciliation Revenue Cycle Management Process Improvement

Senior Associate

Inventures Knowledge Solution

Apr 2017 - Nov 2018 (1 year 7 months)

Handled physician billing for orthotics and prosthetics, resolved claim rejections/denials, analyzed EOBs for payment discrepancies, and conducted internal audits and QA checks.

Internal Audit Client Communication Training Quality Assurance

Senior Associate

Gebbs Healthcare Solutions

Aug 2015 - Dec 2016 (1 year 4 months)

Worked on hospital billing claims, analyzed remittance advice and EOBs, appealed denied claims, submitted electronic and paper claims, and supported continuous performance improvement.

ERA EOB Analysis Claims Appeals RCM Performance Tracking