Looking for a job

praveen negi

@praveennegi1

Medical billing SME at Qualicentric ITES Pvt. Ltd., resolving behavioral health denials and guiding teams across US healthcare RCM.

India

Message

What I'm looking for

I'm targeting RCM Manager, RCM Lead, Medical Billing Manager, or Revenue Cycle Management Specialist roles.

At Qualicentric ITES Pvt. Ltd., I support end-to-end US healthcare revenue cycle management, from claim submission and AR follow-up through denial resolution, appeals, and reimbursement. I investigate behavioral health denials, prepare corrected claims and appeals, and follow up with payers to resolve outstanding billing issues.

I analyze denial trends and AR reports to identify recurring blockers and support revenue recovery. I also guide billing staff and contribute to SOP development and process improvements; previously, I managed claims and AR at CGM ARIA Health Services and UnitedHealth Group (Optum).

Experience

Work history, roles, and key accomplishments

Current

Subject Matter Expert – Medical Billing

Current

Qualicentric ITES Pvt. Ltd.

Aug 2023 - Present (3 years 2 months)

Oversee end-to-end US healthcare RCM activities including claim submission, AR follow-up, denial resolution, appeals, and reimbursement. Analyze denial root causes, resubmit corrected claims, prepare appeals, and guide billing teams on workflows and process improvements.

Revenue Cycle Management Medical Billing AR Management Denial Management Appeals Claim Submission Payer Follow Up EOB Analysis Root Cause Analysis SOP Development Team Mentoring AdvanceMD Aprima Waystar Eemedix LABDAQ Cerner Excel

Senior AR Specialist

CGM ARIA Health Services

Jan 2020 - Aug 2023 (3 years 7 months)

Managed high-volume US healthcare claims from submission through payment, focusing on timely AR resolution. Investigated denials, performed payer calls, resubmitted corrected claims, prepared appeals, and prioritized AR by aging and reimbursement potential.

Accounts Receivable Denial Management Payer Follow Up Claim Correction And Resubmission Appeals EOB Analysis AR Prioritization Revenue Recovery Medical Billing

AR Specialist

UnitedHealth Group (Optum)

Feb 2016 - Jan 2020 (3 years 11 months)

Managed full-cycle US healthcare billing and AR operations including claim submission, payer follow-ups, denial resolution, and payment posting. Verified insurance eligibility, reviewed EOBs, and coordinated with coding and clinical teams to resolve billing issues.