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Rahul Singh Bohra

@rahulsinghbohra

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Senior Quality Analyst for US healthcare medical billing—audits, compliance, and continuous accuracy improvements.

India

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What I'm looking for

I’m looking for a US healthcare billing quality role where I can own audits and compliance (HIPAA/payer guidelines), mentor teams, and drive continuous process improvements to reduce denials and strengthen AR accuracy.

I’m a Quality Analyst with more than 9 years of experience in US Healthcare Medical Billing, specializing in auditing billing processes, ensuring compliance with payer guidelines, and improving operational accuracy. I focus on reviewing claims, validating insurance eligibility and benefits, and making sure everything aligns with HIPAA regulations and client-specific quality standards.

In my current role as Lead Analyst (Quality & CRM), I partner with teams to strengthen claim processing quality end to end. I handle denial management and appeal/correction workflows, monitor accounts receivable aging, and analyze reporting trends to identify root causes and drive continuous process improvements.

I’ve also worked across multiple billing functions—claims follow-up, payment posting, reconciliation, patient billing and collections, audit support, and documentation review. I coach and train analysts using metrics, feedback, and structured quality/production updates, and I’ve supported reductions in escalations by communicating client protocol, SOPs, and new process changes across teams.

I bring strong knowledge of medical billing workflows, claims adjudication, denial management, revenue cycle management (RCM), and quality assurance methodologies. Alongside hands-on billing expertise, I apply DMAIC and CAPA thinking, leverage Lean Six Sigma Green Belt practices, and use tools like Microsoft Excel, PowerPoint, Word, SQL basics, and Power BI to turn data into better outcomes.

Experience

Work history, roles, and key accomplishments

Lead Analyst (Quality & CRM)

Coronis Ajuba

Apr 2022 - Jul 2026 (4 years 3 months)

Led quality and CRM operations for US healthcare medical billing, including claim processing, coding compliance, denial management, AR aging, and HIPAA/payer compliance. Managed a team of 10–15 agents, provided coaching and quality feedback, and generated weekly/monthly production and quality reports.

Medical Billing Quality Audits Claims Processing Insurance Verification HIPAA compliance Denial Management Payment Posting Reporting and Analytics Root Cause Analysis Team Coaching Process Improvement Credentialing and Enrollment Payer Contract Analysis Documentation Review

Account Executive

Miramed Ajuba Solutions Pvt Ltd

Mar 2020 - Nov 2021 (1 year 8 months)

Handled claim follow-ups for unpaid/denied accounts, including insurance verification, denial management, and accurate payment posting. Monitored AR aging, supported billing reconciliation and audit documentation, and ensured HIPAA/payer compliance while managing patient billing and collections.

Claims Follow Up Payment Posting Denial Management Insurance Verification Billing And Collections Payment Reconciliation HIPAA compliance Cash Flow Management Customer Service Audit Support

Senior Process Associate - CRM

Nsight Solutions Pvt Ltd

Apr 2019 - Mar 2020 (11 months)

Processed and quality-checked medical claims for accuracy and compliance, including denial management and AR follow-up to support timely reimbursement. Trained junior staff, generated billing KPIs, ensured ICD-10/CPT coding compliance, and managed client billing inquiries while supporting audit needs.

Claims Processing Denial Management A R Follow Up KPI Reporting ICD 10 Coding Process Improvement Training Client Management HIPAA compliance Billing Software Audit Support

Associate - Accounts Receivable

Technosoft Global Services Pvt Ltd

Dec 2014 - Jun 2016 (1 year 6 months)

Supported accounts receivable operations for medical billing, including AR follow-up, payment posting/adjustments, insurance verification, and denial management. Addressed billing inquiries and disputes, reviewed documentation for billed services, ensured HIPAA compliance, and monitored aging reports using billing software/EHR systems.