Kranthi Sureddy

Professional Summary

Experienced and driven Assistant Manager with over 6+ years of leadership experience and a strong foundation of 15+ years in the US Healthcare Revenue Cycle Management (RCM) industry. Proven expertise in managing large-scale teams, driving process excellence, and implementing technology-driven solutions. Adept at leading high-impact functions including Eligibility and Benefits Verification, AR Denial Management, Payment Posting, and possessing solid knowledge in Medical Coding and full-cycle Medical Billing.

Core Competencies & Achievements:

• RCM Expertise: Deep understanding of the US healthcare revenue cycle, with hands-on experience in:
  Eligibility and Benefits Verification – Ensuring accurate coverage validation for improved claims success.
  Accounts Receivable (AR) & Denial Management – Skilled in root cause analysis, appeal strategies, and resolution tracking.
  Payment Posting – Accurately managing EOBs, ERA files, and reconciliation processes.
  Medical Coding & Billing – Working knowledge of coding systems and complete billing cycle processes for compliance and reimbursement accuracy.
• Client Onboarding & Process Transition: Successfully led multiple client onboarding projects, ensuring seamless knowledge transfer, SOP development, and timely go-lives.
• Team Leadership: Managing a team size of 100+ professionals, driving motivation, quality, and adherence to KPIs through mentorship and performance coaching.
• Technology & Automation Integration:
  Partnered with Tech and RPA teams to roll out automation initiatives aimed at reducing manual effort and improving accuracy.
  Exposure to tools and technologies including UiPath, Playwright, SQL, and front-end technologies, supporting process automation and data-driven decision-making.
• Operational Excellence: Consistently implemented improvements to boost process efficiency, reduce TAT, and enhance client deliverables across RCM functions.
• Stakeholder Engagement: Strong interpersonal skills with experience in coordinating between cross-functional teams, senior leadership, and external clients to align strategic goals and resolve issues promptly.
• Adaptability & Growth Mindset: Agile in managing change, quickly adapting to evolving business needs, and continuously pursuing innovation in service delivery.
• Supervised day-to-day operations to meet performance, quality and service expectations.
• Improved Clients satisfaction by addressing and resolving complaints promptly.
• Developed strong working relationships with staff, fostering a positive work environment.
• Promoted teamwork within the workplace by encouraging collaboration among staff members on various project tasks.
• Collaborated with the management team to develop strategic plans for business growth and improvement.

Experience in AR Management, Denial Handling & Benefits Verification – Medical Services

Skilled RCM professional with hands-on experience in managing the full scope of Accounts Receivable (AR) calling, denial management. Adept at supporting providers in streamlining the billing process and improving claim submission accuracy, resulting in faster reimbursements and reduced rework.

• AR Calling & Follow-Up: Proactively managed aging reports and followed up with dental insurance payers to resolve unpaid claims. Ensured timely collections by addressing claim status inquiries, underpayments, and pending documentation issues.
• Denial Management: Specialized in identifying and resolving common denial trends in dental billing, including frequency limitations, benefit exclusions, and coding inconsistencies. Initiated appeals and corrected claims to accelerate resolution and reduce accounts receivable.
• Provider-Side Billing Expertise: Supported end-to-end medical billing operations for dental practices, including charge entry, claim submission, payment posting, and patient billing. Collaborated closely with providers and office staff to ensure compliance with payer guidelines and billing accuracy.
• Process Improvement: Played a key role in identifying gaps in claim submission processes and implementing corrective strategies to reduce rejections and speed up payment cycles.
• Payer Communication & Documentation: Maintained strong relationships with insurance representatives to expedite issue resolution and ensured accurate documentation was maintained for audits and reporting.

Specialized Experience in AR Calling & Denial Management – Workers' Compensation Claims

Focused and detail-oriented professional with hands-on experience in Accounts Receivable (AR) calling and denial management, particularly in the complex domain of Workers' Compensation (WC) claims. Demonstrated ability to navigate payer-specific policies, resolve claim denials efficiently, and ensure timely reimbursement through diligent follow-up and appeals.

• AR Calling & Follow-Up: Conducted proactive follow-ups with insurance carriers, third-party administrators (TPAs), and state agencies to track the status of outstanding workers' compensation claims and expedite payments.
• Denial Management: Identified patterns and root causes of denials specific to WC claims, including authorization issues, jurisdiction discrepancies, and documentation gaps. Successfully managed appeals and resubmissions, improving claim resolution rates and reducing aging AR.
• Medical Billing Support: Assisted in end-to-end medical billing processes for healthcare providers, with a focus on the unique billing requirements of workers’ compensation cases. Ensured accurate charge entry, modifier application, and compliance with WC state regulations.
• Provider Support & Documentation: Collaborated with providers and medical offices to gather supporting documents such as medical reports, treatment notes, and proof of authorization required for WC claim adjudication.
• Regulatory Compliance: Maintained up-to-date knowledge of workers’ compensation billing rules and payer guidelines across different states to ensure accurate claim submission and minimize compliance risks.

Experience in AR Calling, Denial Management & Provider-Side Medical Billing

Dedicated RCM professional with a strong background in Accounts Receivable (AR) calling and denial management, combined with hands-on experience in provider-side medical billing operations. Adept at managing end-to-end billing workflows, improving claim accuracy, and accelerating revenue recovery for healthcare providers.

• AR Calling & Follow-Up: Conducted in-depth follow-ups with insurance payers to track outstanding claims, resolve payment delays, and address underpayments or rejections. Maintained detailed call documentation and ensured consistent communication with payers for timely collections.
• Denial Management: Analyzed claim denials to identify root causes such as coding issues, missing information, or authorization problems. Managed resubmissions and appeal processes to maximize claim recovery and reduce AR aging.
• Charge Posting: Accurately entered charges into billing systems based on patient encounters, superbills, and coded data, ensuring completeness and adherence to payer-specific billing guidelines.
• Superbill Management: Reviewed and interpreted superbills submitted by providers to ensure all billable services were captured and coded correctly before claim generation.
• Payment Posting: Posted payments from Electronic Remittance Advice (ERA), Explanation of Benefits (EOB), and manual checks with accuracy. Performed reconciliation, adjustments, and write-offs as per payer contracts and billing policies.
• Provider Support & Collaboration: Worked closely with providers, front office staff, and billing teams to resolve discrepancies, ensure accurate documentation, and maintain billing compliance.
• Process Efficiency: Contributed to process improvement initiatives aimed at minimizing denials and enhancing the speed and accuracy of claim submission and revenue posting.