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@viralpatil
RCM professional skilled in medical billing, denial management, and eligibility verification.
I am a CM C certified medical billing and revenue cycle professional with 2+ years of experience improving billing workflows, reducing claim denials, and ensuring compliance with insurance guidelines. I have hands-on experience with Epic, AdvancedMD, Salesforce, and a proven record of improving revenue-cycle efficiency through denial analysis, appeals, and process improvements.
I communicate effectively with payers, providers, and patients to resolve eligibility and claims issues, handle pre-authorizations, and maintain accurate patient and insurance data. I thrive in fast-paced, deadline-driven environments and am seeking to contribute my RCM expertise to healthcare organizations in Malaysia.
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Work history, roles, and key accomplishments
Credence Resource Management
May 2024 - Present (1 year 6 months)
Verify patient insurance coverage and eligibility, manage pre-authorizations, and maintain accurate patient insurance and demographic records to reduce eligibility-related denials and ensure compliance with insurance regulations.
Access Healthcare
Oct 2023 - Apr 2024 (6 months)
Processed medical claims, posted charges and payments, tracked claim denials and payments, and adhered to client SLAs to improve revenue cycle efficiency and reduce outstanding receivables.
Transworld System India
Feb 2022 - Sep 2023 (1 year 7 months)
Managed inbound/outbound calls with insurers to obtain and update insurance information, ensuring accurate system records and supporting collections for hazard insurance accounts.
Gebbs Healthcare
Aug 2021 - Feb 2022 (6 months)
Followed up with payers and patients on outstanding receivables, analyzed accounts to resolve billing discrepancies and denials, and ensured timely submission of claims and accurate documentation.
Degrees, certifications, and relevant coursework
Bachelor of Science, Science
2020 - 2021
Grade: 70%
Completed a Bachelor of Science degree with a focus on foundational science coursework and a final grade of 70%.
Higher Secondary Certificate, Science and Commerce
2017 - 2018
Grade: 43.23%
Completed Higher Secondary Certificate (HSC) with a final percentage of 43.23%.
Secondary School Certificate, General Secondary Education
2015 - 2016
Grade: 70.20%
Completed Secondary School Certificate (SSC) with a final percentage of 70.20%.
Software and tools used professionally
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