Pradeep Sakthi

Experience

• 

  Omega Healthcare Management Services

  Jun 2011 - Jan 2013

  Executive AR

  Headline: "Results-driven Mid-Level Associate with expertise in billing, denials management, and process improvement"- Investigated billing discrepancies and implemented effective solutions to resolve concerns, ensuring accurate and timely payment processing while preventing future problems.- Managed denials and rejections from payers, employing proactive strategies to increase accounts receivable (AR) for clients and optimize revenue generation.- Conducted thorough reviews to accurately apply payments and denials to claims and patient accounts, leveraging Electronic Remittance Advice (ERA) and Explanation of Benefits (EOB) for precise reconciliation.- Proficiently handled online claim submission and retrieval of ERA/EOB, streamlining the posting process and reducing manual effort.- Played a key role in the Credit Balance - Medicare Project, demonstrating strong attention to detail and adherence to regulatory requirements. Show less

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  AGS Health

  Jan 2013 - Dec 2015

  Process Associate - Level 2

  "Detail-oriented Senior Associate in Business Operations specializing in billing and practice management software implementation"- Demonstrated expertise in billing for a wide range of specialties including Anesthesia, Emergency, OB/GYN, Pathology, Physician Assistants, Radiology, and Multi-Health.- Proactively identified non-adjudicated claims, both payer and patient-wise, to ensure timely resolution and submission to the payer.- Proficiently set up practice management software for electronic claims submission, collaborating with clearinghouses to address file compatibility issues.- Meticulously posted and reconciled insurance and patient payments, diligently researching and resolving any discrepancies or incorrect payments.- Effectively handled rejections, denials, and other outstanding account issues, ensuring prompt resolution and maximum revenue recovery.- Ensured the accuracy of insurance claims by verifying correct ICD and CPT codes for various specialties, particularly upon denials.- Managed the retrieval of Electronic Remittance Advice (ERA) and promptly submitted secondary claims after primary insurance processing.- Proactively followed up on insurance and patient aging, resubmitting insurance claims as necessary while adhering to timely filing restrictions and denials.- Compiled comprehensive daily, weekly, and monthly Cash and Charges reports for providers, leveraging expertise in MIS for a period of 1 year.- Maintained strict adherence to HIPAA regulations, ensuring office practices were compliant and patient data was protected. Show less

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  Athenahealth

  Jan 2016 - now

  "Driving customer-centric product innovation and strategic growth as a Product Manager"- Leading cross-functional teams to develop and launch innovative products that meet customer needs and drive business growth.- Utilizing market research and customer insights to identify new opportunities and enhance existing product offerings.- Collaborating with stakeholders to define product vision, strategy, and roadmap aligned with business goals.- Implementing agile methodologies to deliver high-quality products within tight timelines.- Analyzing data and metrics to make data-driven decisions and continuously improve product performance.- Building strong relationships with customers, gathering feedback, and incorporating it into product development.- Keeping up-to-date with industry trends and emerging technologies to stay ahead of the competition.- Championing a customer-first approach and ensuring a seamless user experience throughout the product lifecycle.- Collaborating with cross-functional teams, including engineering, design, and business, to successfully bring products to the end users.- Proactively identifying and mitigating risks to ensure successful product launches and ongoing success. Show less Headline: Results-driven Product Owner with a track record of delivering successful products and driving cross-functional collaboration- Collaborated closely with cross-functional teams to define and prioritize product requirements, ensuring alignment with business goals and customer needs.- Conducted user research and gathered customer insights to inform product decision-making and drive user-centric product development.- Translated business and user requirements into clear user stories, acceptance criteria, and product backlogs for efficient development and delivery.- Worked closely with development teams to ensure timely and high-quality product releases, utilizing agile methodologies and iterative development processes.- Analyzed market trends, competitive landscape, and user feedback to identify opportunities for product enhancements and innovation.- Collaborated with stakeholders to define product vision, strategy, and roadmap, ensuring alignment with business objectives.- Utilized data and analytics to measure product performance, track key metrics, and make data-driven decisions for continuous improvement.- Facilitated effective communication and collaboration between stakeholders, development teams, and other cross-functional partners.- Championed a customer-first approach, advocated for user needs, and ensured a seamless user experience throughout the product lifecycle.- Proactively identified and mitigated risks, addressed technical challenges, and adapted to market shifts to ensure successful product outcomes. Show less "Results-oriented Business Operations Specialist driving efficiency and customer satisfaction through collaborative problem-solving"- Collaborated closely with cross-functional teams to successfully deliver project requirements, develop innovative solutions, and meet tight deadlines.- Fostered strong relationships with stakeholders to identify and implement optimal solutions, resulting in improved customer satisfaction and enhanced problem resolution.- Managed a diverse range of delegated tasks, including the implementation of new projects/workflows such as Incentive Payments, Unpostable Routing Rules, Event Change Rules, and Re-adjudication Rules (2019-20).- Effectively managed various queues, including BLADE, MatchCon, Data Entry, Manual Posting, Overpayments, and Refunds (2016-2018).- Proactively improved business operations by collaborating with team members and customers to identify and implement workable solutions.- Successfully achieved cost-savings by developing functional solutions to complex problems.- Demonstrated self-reliance and adaptability by consistently meeting and exceeding workflow needs.- Maintained up-to-date knowledge through proactive engagement with payers, researching fact sheets, news articles on payers' websites, and continuous learning.- Developed comprehensive SOPs, workflows, and directives both in-house and for vendors across various processes. Show less

  • Product Manager

    Dec 2022 - now

  • Senior Product Management Associate

    Feb 2021 - Nov 2022

  • Healthcare Transactions Associate

    Jan 2016 - Jan 2021