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Tushar Gupta

@tushargupta1

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Senior RCM analyst specializing in US physician billing, charge review, and high-accuracy claim processing.

India

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What I'm looking for

I’m looking to grow in US healthcare RCM, owning charge review and eligibility/authorization workflows while maintaining ~99% accuracy. I enjoy high-volume queues, continuous process improvements, and mentoring teammates in client-calibrated operations.

I’m a Physician Billing Specialist with nearly 2 years of experience in US healthcare RCM, specializing in charge review, eligibility verification, and claim processing. I was promoted to Senior Analyst for my ability to maintain ~99% accuracy while handling high-volume claims.

I process and review claims across Medicare, Medicaid, Commercial, Workers’ Compensation, and VA/PGBA payers, including complex cases like multi-coverage scenarios, behavioral health, and corporate (prison/jail) accounts. I also support rejection workqueues by resolving scrubber-level errors (NPI issues, eligibility errors, DOB mismatches) and coordinating with internal teams to drive clean outcomes.

I actively participate in monthly client calibration calls, implementing process updates within team workflow. I mentor 2+ new joiners on the process, act as a point of contact for team support, and improve turnaround time using MS Excel-based allocation and analytical methods.

Experience

Work history, roles, and key accomplishments

Current

Senior Analyst - R1 RCM

Current

R1 RCM

Oct 2025 - Present (8 months)

Processed and reviewed 90–110 claims/day, ensuring accurate charge review, eligibility, and authorization compliance across Medicare, Medicaid, Commercial, Workers’ Compensation, and VA/PGBA payers while maintaining ~99% accuracy. Mentored 2+ new joiners, supported monthly client calibration calls, allocated 80–100+ claims/day in MS Excel, and resolved scrubber-level rejection errors through payer

Epic Charge Reviews Eligibility Verification Authorization Pivot Tables Rejection Workqueues Mentoring

Analyst - R1 RCM

R1 RCM

Sep 2024 - Oct 2025 (1 year 1 month)

Processed 80–90 claims/day in charge review, performing eligibility verification and authorization checks and validating DOS, POS, diagnosis, and payer details using Epic and payer portals. Maintained ~99% accuracy, supported 277/rejection workqueues by resolving issues like invalid demographics and duplicate coverage, and improved clean claim submission rates through insurance documentation and p

Epic Charge Reviews Eligibility Verification Authorization Real Time Eligibility (RTE)UHC Rejection Workqueues (277)Filtering