Profile Summary

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Name: Girish Kulkarni E-Mail: Girishkulkarni2025@gmail.com

Phone: +91 9052608753/7989414056
Profile Summary:
 Managing Team Functions: Planning and Performance Management (Including performance / Quality
evaluation) for all Team Members.
 Responsible of managing team of 22 members which includes the Day/Mid/Night.
 Leading, Mentoring, Coaching, Monitoring team members to ensure efficiency in project knowledge,
process operations and meeting of individual and group targets.
 Creating and sustaining a dynamic environment that fosters development opportunities and motivates
high performance amongst Team members.
 Responsible for Overall customer service delivery from the both delivery and support.
 Responsible in delivering and gauging the SLA’s, PMS metrics assigned to the Project
Joined IKS as a fresher -Trainee Associate in 2012 & currently working as Team Manager from July 2017)
 Joined IKS as fresher on May 14th 2012 as a Trainee Associate

 Promoted as a senior Associate in the month of June 2014
 Promoted as a Team Coach through IJP in 2016
 Promoted to Team Manager through IJP in July 2017, handling a team size of 22 associates
 Promoted to Senior Team Manager Effective Oct 2021.
SPECIALIZED SKILLS/JOB KNOWLEDGE:
 Specialized in Complete Revenue Cycle Management includes Insurance verification, Billing, Account
Receivable Follow up, Payment posting, Quality and Transaction audits.
 Knowledge of US Healthcare claims life cycle covering commercial, government, re-pricing or managed
care and the bottlenecks at each stage.
 Knowledge of US Healthcare Philosophy and functioning, the different types of payers, payment
mechanisms and systems, types of contracts and contractual terms, kinds of plans and revenue
generation cycle etc.
 Strong Data analysis skills.
 Worked in different departments like AR follow up, Payment posting, Billing, Eligibility verification and
charge entry.
 Having experience in quality team and have done audits on billing, AR follow up, Eligibility verification,
appeals, Adjustments
 I am well versed in understanding contracts of different payers.
 Have been a part of Billing and AR department, I have gained good knowledge on how the claim
generated from patient registration to claim coding then to billing team and finally to the cash posting
team.
 I have good knowledge on how the front-end rejections occur.
 I have good healthcare exposure and I know how the process work, which makes me to simplify any
job which is given to me.
 I will look up for new ideas by thinking out of box to simplify the work by escalating the claim of similar
scenario.
 Always been maintaining a good track record of all the process updates which is the priority criteria for
maintain good quality scores overall till date.
Roles & Responsibilities:
 Responsible of managing team of 22 members which includes the Mid/Night shift.

 Analyzing the individual agents work, providing feedback, and share knowledge for much effective
performance.
 Ensuring team/individual productivity and targets are met/exceeded.
 Recommend procedural changes required to enhance the productivity
 Recommended and recognized team member’s performance to manager.
 Participated in the quarterly performance reviews of the team members and update the manager and
assistant manager on the team member’s performance on a periodic basis.
 Always met team’s productivity targets set by the project guide lines.
 Enhancing the efficiency and effectiveness of clients revenue generation cycle and liquidation of
Account receivable.
 Look into the needs of the Team and drive the team towards higher productivity and quality levels.
Also, escalate any unresolved queries and issues.
 Performance recognition recommendation for awards for team members in the team.
 Interact with quality and operation team to identify and resolve bottlenecks on quality front to
maximize claims resolution.
 Share an excellent relationship not only with the team but also with other teams and also
approachable and share a good relationship with the other operations like Business analysis team, QA
team, IT team, Onsite staff and Support staff.
 Assist in the training of new team members and in integrating them into the projects in co-ordination
with the Manager and/or designated trainers.
 Having bi-weekly one-to-ones with all the team members to review their performance and resolving
issues.
 Documentation and process flow creation for training.
Team Manager Roles and Responsibilities

 Handling weekly/bi-weekly client calls. Preparing Issue tracker
 Preparing Work order strategy on Monthly basis OR as in when required
 Boxing of denial inventory and providing directional work order to the team
 Preparing monthly decks for (Internal/external) business review meetings
 Mitigating with BI (Business Intelligence) team on delegation of reports
 Strategizing for account receivable from the insurances reduction for the client.
 Analyzing the outstanding inventory and suggesting the best practices do the work order allocation
accordingly to ensure better numbers are produced and to increase the collections
 Identifying trends in payments by the various insurance like, commercial, auto insurance, no fault,
reprising as well as government payers and making efforts to improve them by better methods of
follow up.
 Work closely with the onsite support team and keeping them abreast about developments in coding,
appealing, common errors billing in charge capturing, mailing of the US health care claims which result
in delayed payments.
 Assist in inducting of new members and integrating them in to the project team.
 Training individuals/team on new procedures, new systems are remedial training as and when
necessary.
 Monitor the day to day inflow of AR and make sure aged AR is in control
 Constantly identifying the training needs of the project and ensure that each of the team members is
certified in their assigned positions.
 Attending client meetings and updating team the same.
 Worked on multiple projects
 Worked on all payer mixed denials which are resulted in achieving more collection
 Cleared all online related subjects on the projects which I have exercised to verify (Claim status, online
claim reprocessing, uploading online EOB’s/EFT’s and checking Auth/Referral status).
 Updated an online claims status report of Aetna through which we trimmed down the current payment
days as we are working on conditional days.
 Found a trend in sorting AR ATB to make ongoing accounts, unworked, due for follow up client pending
QA return and delinquent accounts.
 Identified several functionalities with different websites such as creating access, policy validation, use
of Pay span and MR submission.
 Reviewing day to day fax responses and assigning the same to the agents requested the fax, educate
the team to fix the issue then and there if necessary.
Additional Responsibilities
• Handling the Critical Care process for NICU/PICU and sub specialty divisions. Able to reduce the DOS
to <40 from 54 days
• Received many client appreciations for best performance of the establish Critical Care Team
• Leading all Bi-weekly Client calls
• Part of Denial prevention Committee and providing the Denial analysis with preventive actions by
identifying issues/trends by weekly to the denial prevention committee
Organization and Time Management:
 Problem solver who quickly grasps complex situations and works them into achievable jobs.
 Produce quality work under extreme time pressure and deadlines.
 Proven ability to interpret and follow complex instructions to successful closings.
 108 months of experience organizing time and work load.
Working on denials:
Resolved many denial issues in the project, which are as follows:
 Coding denials.
 Referral/Auth denials.
 E/M code denials
 Taxonomy denials.
 Provider credential denials.
 Prefix and Plan wise BCBS denials.
Growth path in RCM:
 July 2012-June 2014 Trainee Associate AR & Denials (IKS Health)

 July 2014- June 2016 Senior Associate AR & Denials (IKS Health)
 July 2016- Aug 2017 Teach Coach (IKS Health)
 Sept 2017- Sept 2021 Team Manager (IKS Health)
 Oct 2021- Current Senior Team Manager (IKS Health)
Personal profile:
NAME : Girish Kulkarni
Father’s name : Ananth Rao Kulkarni
D.O.B : 19th March 1990
Gender : Male
Nationality : Indian
Marital Status : Single.
Languages known : English, Hindi, Kannada & Telugu.
Personal Skills : Leadership qualities, Confident, Reliable, and Flexible.
DATE:
PLACE: Hyderabad.
SIGNATURE
(GIRISH KULKARNI)

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Resume

Name: Girish Kulkarni E-Mail: Girishkulkarni2025@gmail.com

 Joined IKS as fresher on May 14th 2012 as a Trainee Associate

SPECIALIZED SKILLS/JOB KNOWLEDGE:

Roles & Responsibilities:

 Responsible of managing team of 22 members which includes the Mid/Night shift.

Team Manager Roles and Responsibilities

 July 2012-June 2014 Trainee Associate AR & Denials (IKS Health)

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