Rahil Ahmed

Finance and Operations Specialist | Revenue Cycle Management & Compliance Expert

Bengaluru, IN.

About

Detail-oriented finance and operations professional with over 3 years of experience in compliance, reconciliation, and process optimization within fast-paced environments. Adept at claims lifecycle management, stakeholder coordination, and ensuring stringent adherence to regulatory standards. Seeking to leverage proven expertise in financial operations and compliance to drive strategic impact within a dynamic consulting environment, focusing on enhancing audit-readiness and operational efficiency.

Work

PwC (PricewaterhouseCoopers)

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Specialist - RCMS

Bengaluru, Karnataka, India

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Summary

Currently supports compliance-driven financial operations within a Big 4 consulting environment, ensuring adherence to process standards and enhancing audit-ready documentation.

Highlights

Supports compliance-driven financial operations, ensuring stringent adherence to process standards and regulatory guidelines within a high-volume, process-driven Big 4 consulting environment.

Assists in critical reconciliation activities, contributing to the preparation of audit-ready documentation for complex financial processes.

Collaborates effectively with cross-functional teams to maintain robust data accuracy and elevate reporting quality for key stakeholders.

Monitors crucial Key Performance Indicators (KPIs) and actively contributes to process improvement initiatives, enhancing operational efficiency and compliance.

Ensures rigorous quality control and compliance across diverse financial and operational deliverables, minimizing risk and ensuring regulatory adherence.

Allegis Group

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Program Specialist

Bengaluru, Karnataka, India

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Summary

Coordinated operational workflows and ensured Service Level Agreement (SLA) adherence, while monitoring process performance and supporting compliance requirements.

Highlights

Coordinated complex operational workflows, consistently ensuring Service Level Agreement (SLA) adherence and optimizing process efficiency.

Monitored process performance against quality standards, identifying areas for improvement and contributing to enhanced operational excellence.

Supported comprehensive documentation review and compliance requirements, ensuring accuracy and regulatory alignment.

Assisted in crucial reporting and facilitated effective stakeholder communication, contributing to informed decision-making and transparency.

Omega Healthcare Management Services

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Senior AR Executive / Prior Authorization Specialist

Bengaluru, Karnataka, India

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Summary

Managed the full revenue cycle, performing AR calling, denial management, and claim resubmissions to optimize collections and reduce outstanding medical claims.

Highlights

Performed targeted AR Calling to insurance payers, successfully following up on outstanding medical claims and accelerating collections.

Verified claim statuses and meticulously identified reasons for non-payment or delays, streamlining the resolution process.

Handled complex denial management by analyzing denial codes and initiating precise corrections or appeals, improving claim acceptance rates.

Managed claim resubmissions and documentation updates in strict accordance with payer requirements, minimizing rejections and ensuring compliance.

Maintained consistent follow-ups via calls and payer portals, significantly reducing AR aging and enhancing cash flow efficiency.

Coordinated effectively with internal teams to swiftly resolve billing and documentation issues, improving inter-departmental collaboration and claim processing speed.

Managed assigned AR queues, ensuring timely claim resolution and maintaining high productivity and quality metrics as per established process standards.

Education

Karnataka College of Management and Science

Bengaluru, Karnataka, India
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Bachelor of Commerce (B.Com) Commerce

Languages

English

Skills

AR Calling & Insurance Follow-ups

AR Calling & Insurance Follow-ups.

Denial Management & Appeals Handling

Denial Management & Appeals Handling.

Revenue Cycle Management (RCM)

Revenue Cycle Management (RCM).

Prior Authorization Processing

Prior Authorization Processing.

Policy & Eligibility Verification

Policy & Eligibility Verification.

Documentation Review & Compliance

Documentation Review & Compliance.

Claim Status Verification

Claim Status Verification.

Aging & Escalation Management

Aging & Escalation Management.

KPI & SLA Adherence

KPI & SLA Adherence.

MS Excel & Reporting

MS Excel & Reporting.