Kapil K

Billing Specialist

Jul 2021 - Present • 5 yrs 4 mos

Worked as a Healthcare Billing Specialist II at Wipfli India LLP, managing complex revenue cycle operations, accounts receivable, and billing workflows for US-based healthcare facilities, specifically specializing in Home Health and Skilled Nursing Facilities (SNF). Responsible for driving optimal reimbursement outcomes, overseeing claim lifecycles, resolving intricate billing and denial escalations, and mentoring team members to ensure operational efficiency and adherence to regulatory compliance. Key Responsibilities & Achievements Specialized RCM Management: Managed end-to-end billing, AR follow-ups, and denial resolutions for Home Health and Skilled Nursing Facility (SNF) accounts, ensuring compliance with payer guidelines and reducing aging receivables. Team Leadership & Mentoring: Guided and supported team members on daily billing workflows, escalation handling, and complex claim re-submissions, fostering high performance and quality output. Denial & Discrepancy Resolution: Investigated high-value denials, short-payments, and claim rejections across diverse payers, implementing root-cause corrections to optimize cash flow. Process Optimization: Streamlined AR tracking and reporting procedures, improving operational turnaround times and maintaining high accuracy across medical billing platforms. Payer & Client Collaboration: Liaised directly with US-based insurance carriers and internal stakeholders to resolve billing disputes, verify patient eligibility, and expedite collections.

Account Receivable

Jun 2019 - Jul 2021 • 2 yrs 1 mo

Worked as an Accounts Receivable Specialist managing end-to-end medical billing and RCM processes for US-based pain management facilities. Responsible for daily revenue cycle operations, claim lifecycle management, and maximizing reimbursement efficiency while ensuring strict adherence to healthcare compliance standards Key Responsibilities and Achievements AR Follow-Up & Denial Management: Claims Processing & Resolution: Denial Trend Analysis: Payer Communication Client Communicatio.