Anoop Ramesh
Abu Dhabi
Summary
Results-driven RCM Manager with over 14+ years of experience in Revenue Cycle Management, Medical Billing, Insurance Operations, and Medical Data Analysis. Expertise in inpatient and outpatient coding, denial management, claims processing, and process optimization. Adept at leading teams, implementing automation, ensuring regulatory compliance, and driving revenue growth through strategic initiatives. Passionate about quality auditing, training, and digital transformation in the healthcare industry.
Overview
14
14
years of professional experience
1
1
Certification
Work History
RCM Manager
Clemenceau Medical Center Hospital
04.2024 - Current
- Develop, implement, and enforce policies, procedures, and productivity standards to enhance operational efficiency
- Establish and maintain a system to ensure accurate billing information is recorded and processed effectively
- Generate detailed reports for senior management to monitor team progress and performance
- Implement key performance indicators (KPIs) to reduce turnaround times and enhance productivity while maintaining quality standards
- Supervise revenue cycle functions, including account management, insurance communications, Claim Submission, cash posting, contract analysis, and billing
- Collaborate with physicians to address medical necessity-related denials and implement preventive strategies
- Review and assess financial hardship applications for appropriate resolutions
- Strategically plan and structure departmental workflows to optimize staffing efficiency
- Mentor and guide direct reports by defining responsibilities, setting performance expectations, and fostering professional growth
- Address and resolve patient complaints related to billing and collections in a timely manner
- Lead final reconciliations with insurance companies to ensure proper revenue recognition
- Prepare and analyze revenue and receivable reports while coordinating closely with the finance team
- Negotiate insurance policy coverage, evaluate applications, and determine optimal options for various projects
- Enhance insurance coverage for the organization by analyzing historical claims data and implementing appropriate risk financing strategies
- Strengthen hospital network competitiveness by expanding network accessibility
- Work closely with executives, senior management, and business associates to identify hospital requirements and negotiate cost-effective insurance coverage and claim settlements
- Lead insurance credentialing processes and negotiate new tariff agreements in line with corporate policies
- Conduct training and orientation programs to ensure staff compliance with policies and procedures
- Maintain adherence to all coding guidelines and regulatory compliance requirements
- Oversee collection follow-ups and ensure efficient receivable management
- Provide continuous staff performance feedback through regular reviews and one-on-one meetings
- Oversee recruitment, onboarding, training, assessment, and career development of employees
Billing and Revenue Recovery Officer
Sheikh Shakhbout Medical City
10.2022 - 03.2024
- Developed scrubber database with paid diagnosis for initial top 65 CPT denials clean claim submissions and rejection analysis
- Developed training programs for billers and coders to enhance accuracy
- Implemented strategies to reduce initial rejections and optimize reimbursement
Supervisor - Medical Coding
Imperial College London Diabetes Center
01.2022 - 09.2022
- Led a team of 16 coders, ensuring compliance with medical coding regulations
- Acquired above 96% accuracy in JAWDA audit across 3 branches of ICLDC
- Conducted audits and provided feedback to enhance accuracy
- Improved claim acceptance by identifying and mitigating rejection trends
Senior Coder
Imperial College London Diabetes Center
04.2017 - 12.2021
- Maximized revenue through Evaluation & Management (E/M) coding optimization
- Conducted quality audits and training on insurance policies
- Led RCM policy development to ensure regulatory compliance
- Scrubber backend database for 100+ CPTs
Resubmission Analyst, Medical Coding & Billing Trainer
Dublin Healthcare Management Pvt Ltd
01.2014 - 03.2017
- Managed resubmissions for 22 insurance companies across multiple hospitals
- Developed training programs, mentoring 150+ medical coders
- Assisted in insurance price negotiations and utilization review meetings
Senior Medical Coder
E4E Healthcare Solutions
07.2013 - 12.2013
Senior Medical Coder
Omega Healthcare Management Services Pvt Ltd
10.2010 - 07.2013
Education
MBA - Hospital & Healthcare Facilities Administration
National Institute of Business Management
India01.2022
Bachelor of Science - Nursing
Rajiv Gandhi University of Health Sciences
Bangalore, India03.2012
Skills
- Revenue Cycle Management (RCM)
- Medical Billing & Coding (ICD-10-CM, CPT-4, HCPCS)
- Denial Management & Resubmission
- Claims Processing & Reconciliation
- Process Improvement & Automation
- Quality Auditing & Compliance
- Training & Team Leadership
- Healthcare Regulations & TPA Alignment
- Scrubber Management & Digital Transformation
- Microsoft Office & Data Reporting
Certification
Certified Professional Coder (CPC), American Academy of Professional Coders (AAPC)
Languages
English
Malayalam
Hindi
Tamil
Personal Information
- Nationality: Indian
- Driving License: UAE Category
- Marital Status: Married
- Visa Status: Job Visa
Timeline
RCM Manager
Clemenceau Medical Center Hospital
04.2024 - Current
Billing and Revenue Recovery Officer
Sheikh Shakhbout Medical City
10.2022 - 03.2024
Supervisor - Medical Coding
Imperial College London Diabetes Center
01.2022 - 09.2022
Senior Coder
Imperial College London Diabetes Center
04.2017 - 12.2021
Resubmission Analyst, Medical Coding & Billing Trainer
Dublin Healthcare Management Pvt Ltd
01.2014 - 03.2017
Senior Medical Coder
E4E Healthcare Solutions
07.2013 - 12.2013
Senior Medical Coder
Omega Healthcare Management Services Pvt Ltd
10.2010 - 07.2013
MBA - Hospital & Healthcare Facilities Administration
National Institute of Business Management
Bachelor of Science - Nursing
Rajiv Gandhi University of Health Sciences
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