mounika b

I’ve worked across U.S. healthcare revenue cycle operations, from AR follow-up in eClinicalWorks (ECW) to clearinghouse billing and eligibility verification. At RI RCM Pvt Ltd, I supported the “AR Caller” workflow to manage and resolve outstanding insurance claims for a CPS client.

I review aging accounts receivable reports, prioritize high-balance and overdue claims, and contact commercial, Medicare, and Medicaid payers via phone and payer portals. I identify denial root causes—coding errors, eligibility issues, and missing authorizations—then drive corrective actions, reconsiderations, and appeal letters with supporting clinical documentation.

I coordinate with coding and billing teams to correct and resubmit rejected or denied claims within payer timelines, and I document payer responses and resolution notes in ECW. I also generate billing performance reports and monitor EDI acknowledgment and rejection streams (EDI 999/277CA, ERA/835) to resolve discrepancies promptly.

Before that, as a Sr. Process Consultant at Hinduja Global Solutions, I handled medical billing operations for U.S. clients, ran end-to-end claims processing, and improved SOP-based procedures while staying compliant with HIPAA. I’ve also trained new joiners on ECW workflows and payer-specific guidelines.