Karthik S.
Mid-Level Healthcare Revenue Cycle Manager
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About
Karthik S. has demonstrated expertise in revenue cycle management, particularly in the healthcare industry. At Forefront Healthcare, he served as a Senior Revenue Cycle Auditor, where he reviewed quality requirements, rectified trending errors, and provided training on error types to enhance the productivity and quality of A/R Associates. His role involved supervising medical billers and setting performance targets to ensure team efficiency in denial resolution and claim accuracy. Previously, as a Project Lead at HCLTech, he oversaw the entire revenue cycle process, from claim submissions to payment reconciliation, and acted as a crucial contact for clients and insurance providers. At Omega Healthcare Management Services, he held the position of Quality Control Analyst, overseeing internal audits and compliance with HIPAA and payer guidelines while leading a team to achieve a high acceptance rate in quality control. His earlier roles included optimizing claims processing and resolving payment discrepancies, continually leveraging tools such as SAP and Oracle for efficient revenue management.
Experience
SENIOR REVENUE CYCLE AUDITOR (BUSINESS EXCELLENCE - QUALITY)
FOREFRONT HEALTHCARE · 2025 — 2026Reviewed and validated quality requirements for the client SOP. Rectified trending errors to identify training opportunities and conducted feedback sessions for A/R Associates and team leaders to assess previous day's quality results. Provided training weekly or through one-on-one actions based on the types of errors corrected. Instructed agents on quality guidelines and pre-auditing procedures to minimize errors. Trained new A/R Associates to enhance their productivity and quality in alignment with management expectations. Guided associates in the Process Improvement Program due to low quality records. Supervised and provided guidance to a team of medical billers, AR specialists, and payment posting executives. Trained new members on RCM processes, payer guidelines, and best practices. Set performance targets while ensuring the team met key performance indicators such as denial resolution and claim submission accuracy.PROJECT LEAD
HCLTECH · 2024 — 2025Monitored the complete RCM process from patient registration through final payment reconciliation. Ensured timely claim submission, denial management, and payment posting. Identified and resolved billing errors and claim denials to minimize revenue loss, while working to reduce days sales outstanding and enhance cash flow. Oversaw accurate claim processing and submission to insurance providers, analyzing denials and underpayments to determine root causes. Implemented corrective actions aimed at reducing denial rates. Ensured compliance with HIPAA regulations, payer guidelines, and maintained updated knowledge of insurance policies and coding regulations. Served as the main point of contact among the RCM team, clients, healthcare providers, and insurance companies. Coordinated with various teams to address billing discrepancies while fostering client satisfaction. Analyzed billing trends and generated regular reports on collections, denials, and outstanding claims, providing recommendations for improvement.QUALITY CONTROL ANALYST
Omega Healthcare Management Services Pvt. Ltd · 2022 — 2024Communicated quality metrics updates to the team, highlighting consistency issues and production deficiencies. Reviewed and validated quality requirements for client SOPs while rectifying trending errors to deduce training opportunities. Conducted feedback sessions for A/R Associates, including team leaders, to assess previous quality outcomes. Provided ongoing training, focusing on specific error types on a weekly basis or through individualized sessions. Instructed agents on quality guidelines and pre-audit practices. Successfully trained new A/R Associates, optimizing their productivity and quality as per management standards. Guided associates enrolled in the Process Improvement Program to enhance quality performance. Conducted internal calibration sessions with operations, creating preventive and corrective action plans to address root causes of errors.SENIOR A/R EXECUTIVE
Omega Healthcare Management Services Pvt. Ltd · 2019 — 2021Managed clean claims submission to insurance carriers, expedited payments to providers, and followed up on delinquent or denied claims. Worked on payer rejections and denials, collaborating with billers and Revenue Cycle Manager to address past due accounts. Contacted insurance payers for further examination of outstanding accounts receivables, while obtaining prior authorization for significant healthcare services including radiology and major surgeries. Evaluated unpaid health insurance claims and coordinated the transfer of outstanding balances to patients when applicable. Coordinated closely with payers to resolve provider credentialing issues for unresolved claims while meeting monthly productivity and quality targets.PROCESS DEVELOPER
GENPACT · 2016 — 2017Generated various reports from SAP and allocated invoices accordingly. Reconciled reports by receiving data from vendors. Efficiently managed and allocated invoices based on aging, ensuring compliance with service level agreements while maintaining a positive rapport with clients through excellent service.SENIOR PROCESS ASSOCIATE
ACCENTURE INDIA PVT LTD · 2012 — 2013Utilized SAP for processing invoices within the P2P process and was part of the vendor reconciliation team, also working with VIM Analytics. Handled the collection process for major clients using SAP. Developed SOPs and processed them within MS Dynamics according to business guidelines. Conducted internal audits and forwarded invoice journals for approval. Coordinated urgent payments with specific vendors as priority while reviewing Time and Expense Receipts in SAP Concur.PROCESS ASSOCIATE
EXL SERVICE (OPI) · 2011 — 2012Recorded month-end and day-one accrual entries in SAP for bank report balancing. Cleared accrual postings and recorded daily transactions, including cross-currency and inter-company receipts. Prepared daily and monthly accounts receivable reports while managing customer discounts and handling non-receivables payments. Created monthly and daily journal vouchers for fund transfer and resolved cash queries from SMEs and the GL team.F & A DELIVERY EXECUTIVE
IBM DAKSH · 2010 — 2011Processed invoices for the FMCG sector, specifically for Unilever, using the DCIW tool. Followed standard client procedures to maintain accurate levels of invoice processing while sharing process knowledge with new joiners.
Skills & Expertise
Education
- B.ComD.Banumaiah’s College · 2005 — 2008
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