KIRAN KUMAR K
Dubai,UAE
Summary
Accomplished professional with expertise in healthcare billing and revenue cycle management. Demonstrates strong leadership competence and ethical standards, ensuring efficient operations and compliance. Skilled in workplace mediation and technical proficiency, contributing to a harmonious and productive work environment. Committed to leveraging these skills to drive organizational success and enhance operational efficiency.
Overview
9
9
years of professional experience
2011
2011
years of post-secondary education
1
1
Certification
Work History
RCM Supervisor
MEDICLINIC PARKVIEW HOSPITAL
Dubai
12.2021 - Current
- Spearheaded comprehensive Revenue Cycle Management (RCM) operations, from claim submission to reconciliation, ensuring seamless financial workflows within hospital.
• Strategically monitored and improved monthly revenue collections while
effectively reducing Days Sales Outstanding (DSO).
• Diligently followed up with corporate clients to expedite payment processes and maintain healthy cash flow.
• Conducted regular meetings with department heads to synchronize physician practices with insurance protocols, significantly minimizing claim rejections.
• Provided critical updates on accounts receivable, collections, denials, and financial challenges during weekly and monthly management meetings, proposing actionable solutions and celebrating key successes.
• Collaborated with Legal department to manage licensing and contractual agreements, ensuring compliance and mitigating risks.
• Drove process improvements and fostered effective communication between clients and payers, enhancing overall service delivery.
• Delivered on key organizational performance indicators (KPIs), demonstrating measurable success in revenue cycle efficiency.
• Created and presented comprehensive monthly performance dashboard to provide transparent insights into RCM metrics.
• Guaranteed timely claim submissions and resubmissions, adhering to strict turnaround times (TAT) for optimal financial outcomes.
• Led enhancement of Electronic Record System (TRAKCARE), streamlining data management and improving operational efficiency. Submission, resubmission, Denial management, Collections reports, Data management - Responsibilities: To reconcile unpaid claims for previous years, identifying quality errors on submission, coding, resubmission and educating Front end, data entry, submission and claims processing team to maintain excellent revenue with minimal rejections, framework work pattern, strategies based on payer need, identify revenue
- Leaks and suggest solutions, orient internal and external customers, maintain excellent business relation.
Insurance and Reconciliation supervisor
Zulekha Hospital
12.2019 - 11.2021
- Pre-authorization decision making, coordinating with insurance companies for approval of outpatient requests as well as inpatient requests
- Verification/Medical Audit, E-Claim submission Developing strategies for betterment of process flow of Insurance department, developing HIMS solutions
- Lead Recon teams and claims processing department -
- Preauthorization, Claim processing, submission, resubmission and
- Reconciliation
- Monitor critical areas such as Medical coding, Insurance billing, preauth-TAT, Denial Management and customer handling
- Team building, Maintain quality indicators (Error rate, Rejection rate, TAT), analyzing variances, initiating corrective actions, problem solving, regular training & orientation of employees on different process like Approval, claim verification & processing, reconciliation, E-Claims, and DRG system etc
- Coordinating and enforcing policies, developing standard operating procedures, and maintain productivity standards, work for results.
- Led team meetings, ensured clear communication amongst all members.
- Managed daily operations to increase productivity.
- Provided constructive feedback to staff for improved performance levels.
- Ensured smooth operations with regular maintenance checks.
Reconciliation Officer
ACCUMED Practice Management
Dubai
03.2016 - 09.2018
- Providers handled: Iranian Hospital Dubai Saudi German Hospital MOPA (Ministry of
- Presidential affairs) Mena labs Medical Laboratories Gulf International Cancer, Medical Laser Centre, Dental.
- Responsibilities: To lead the team of Contracting & Pricing, Plan, design and framework the work pattern, strategies business plan based on provider need, identify revenue leaks and suggest solutions, orient internal and external customers, maintain excellent business relation
- Mobile: +971588770039
- KIRAN KUMAR K
- MBA - CPC
- Tasks: Analyze provider profile, initiate new empanelment/network inclusion, initiate tariff revision considering the current and projected revenue, thorough review & negotiation of contracts & pricing, DRG Analysis & negotiation, automation of processes through HIMS, monitoring insurance billing.
Education
MBA - Finance
Ambedkar University
01.2015 - 01.2017
Bachelor - Commerce
Karnataka State Open University
Mysore 01.2011 - 01.2014
Pre-university course - Commerce
Karnataka State Open University
Mysore 01.2014 - 01.2015
High School Diploma - Secondary School Leaving Certificate
Saint Philomenas High School
04.2005
Skills
- Workplace mediation
- Technical proficiency
- Ethical standards
- Leadership competence
- Healthcare billing
- Revenue cycle management expertise
Certification
- CPC Certification from AAPC
- Lean Six Sigma certification
Custom
Designing cover pages, flyers, advertisement pages Theme drawings for conferences Travelling, photography, physical fitness
Personal Information
- Passport Number: M1852984
- Passport Expiry Date: 10/09/24
- Date of birth: 03/17/90
- Gender: Male
Timeline
RCM Supervisor
MEDICLINIC PARKVIEW HOSPITAL
12.2021 - Current
Insurance and Reconciliation supervisor
Zulekha Hospital
12.2019 - 11.2021
Reconciliation Officer
ACCUMED Practice Management
03.2016 - 09.2018
MBA - Finance
Ambedkar University
01.2015 - 01.2017
Pre-university course - Commerce
Karnataka State Open University
01.2014 - 01.2015
Bachelor - Commerce
Karnataka State Open University
01.2011 - 01.2014
- CPC Certification from AAPC
- Lean Six Sigma certification
High School Diploma - Secondary School Leaving Certificate
Saint Philomenas High School
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