Open to opportunities

Nandha Kumar

@nandhakumar5

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Quality Analyst with 6+ years in US healthcare medical billing and audits.

Zimbabwe

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What I'm looking for

I seek a role where I can improve billing quality and processes, lead audits and training, reduce claim errors, and contribute to measurable operational improvements in a collaborative healthcare team.

I am a Quality Analyst with over six years of experience in US healthcare medical billing, specializing in auditing, process improvement, and compliance. I have led end-to-end audits across charge entry and payment posting, maintained HIPAA and payer compliance, and implemented audit checklists that raised compliance to 98%.

I focus on root cause analysis (RCA), corrective and preventive actions (CAPA), and escalation handling to reduce errors and improve client satisfaction. I have driven clean claim rates above 95% and improved new-hire accuracy by 20% through targeted training and refresher sessions.

I am skilled at producing MIS dashboards and quality reports, mapping billing workflows, identifying bottlenecks, and delivering actionable feedback to teams. I bring a continuous-improvement mindset and strong leadership to help organizations reduce errors, accelerate first-pass resolution, and sustain high-quality outcomes.

Experience

Work history, roles, and key accomplishments

Financial Transaction Executive

4d Global Medical Billing

Jan 2022 - Jan 2025 (3 years)

Reviewed patient demographics, charges, coding and claim submissions for accuracy and maintained turnaround time for charge entry to prevent claim delays, achieving high clean claim rates.

EOB ERA Matching TAT Management

Quality Analyst

Qway Technology

Jan 2022 - Dec 2022 (11 months)

Conducted end-to-end audits (charge entry, payment posting), implemented audit checklists to raise compliance to 98% and provided error trend analysis and training to improve accuracy by 20%.

Auditing Process Improvement Training Development DPU DPMO CAPA

Quality Analyst

Accuterm

Performed quality reviews, maintained RCA error logs, handled client escalations and implemented corrective and preventive actions to improve audit accuracy and client satisfaction.

Quality Assurance CAPA Audit Reporting Training & Compliance

Processor

Office Ally

Managed medical claims processing tasks including edits resolution, pended exceptions, and mail-backs while verifying benefits and provider details against payer databases.

Claims Processing Edit Resolution Pended Exceptions Provider Verification HCFA UB Forms Payment Posting

Quality Analyst

Exela Technology

Performed quality assurance on medical claims processing, improving clean claim rate to 95%+ by minimizing coding and demographic errors and ensuring accurate payment posting.

Medical Billing Claim Adjudication Payment Posting CAPA EOB ERA Reconciliation