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Tushar Sharma

@tusharsharma

Associate Operation Manager at R1RCM

Ghaziabad

R1RCMNational Victor Public School

Tushar Sharma is an experienced professional focused on US Healthcare Revenue Cycle Management (RCM). He excels at collaborating with clients to identify system gaps and meet detailed design requirements. His expertise covers AR follow-up, compliance (HIPAA, HITECH), and managing complex EHR solutions like Cerner and MyChart. He has a strong background in billing guidelines and process improvement.

Experience

Associate operation Manager

R1RCM

Full-time•Jan 2022 - Present•Ghaziabad

Handling Team of 35+ Associates for US Healthcare AR Follow-up. Handling all new hired Management trainee reports and giving them regular training with feedback session. Getting into weekly client calls for the Functional Review & touch base calls with the CBO(s) discussing over general issues in AR and reduction plan for 180+ aged AR. Handling weekly Calibration calls for the quality improvements in team. Handling client side queries and solutions for both Clinical EHR (R1 decision) and Facility EHR (E-premise, Cerner) solutions and Patient Charts (MyChart, iDocs). Working as per Federal and State Medical Guidelines CMS (Centers for Medicare & Medicaid Services). Following Healthcare Compliance (HIPPA, HITECH, ePHI) for US Healthcare RCM. One on one Sessions with New hired MT's and Senior analyst. Regular touch with HR for interview of new hires and process requirement. Creating new SOP's for new process. Evaluating business requirements, uncovering areas of improvement, implementing solutions with overall development as per client requirements. Working on business requirements docs, process flows and templates. Directly reporting to stakeholders and directors for various meeting with productivity and quality reports.

Assistant Manager

R1RCM

Full-time•Aug 2020 - Dec 2021•Ghaziabad

Handling Team of 15+ Associates for US Healthcare AR Follow-up. Getting into weekly client calls for the Functional Review & touch base calls with the CBO(s) discussing over general issues in AR and reduction plan for 180+ aged AR. Handling weekly Calibration calls for the quality improvements in team. Handling client-side queries and solutions for both Clinical EHR (R1 decision) and Facility EHR (E-premise, Cerner) solutions and Patient Charts (MyChart, iDocs). Working as per Federal and State Medical Guidelines CMS (Centers for Medicare & Medicaid Services). Following Healthcare Compliance (HIPPA, HITECH, ePHI) for US Healthcare RCM. Working on transition business gathering critical data and sharing final reports with stakeholders.

Management Trainee

R1RCM

Full-time•Jan 2020 - Aug 2020•Ghaziabad

Handling Team of 25 Associates for US Healthcare AR Follow-up. Working towards process improvement and quality. Working on updated ICD-9, ICD-10, CPT, HCPCS coding and Billing guidelines (both CMS-1500 and UB04 claims). Working on EHRs (E-premise, Cerner) solutions and Patient Charts (MyChart, iDocs) for facilities assigned. Following Healthcare Compliances (HIPPA, HITECH, ePHI) for US Healthcare RCM. Get in touch with client on weekly basis for making strategies for the resolution of stuck AR. Maintaining dashboard with improvements that we made in projects.

Sr. Analyst

R1RCM

Full-time•Aug 2018 - Dec 2019•Ghaziabad

Calling Insurance for resolving denial on claims. Working on R1 decision for Clinical and Medical claims, also for Facility EHR using Cerner & E-premise solutions and MyChart, iDocs for Patient Charts. Working towards payment on denied and stuck AR claims within Timely Filling Limit. Handling Mentorship role for 6 associates and turning them into an Expert associate. Calling Insurance for resolving denial on claims and clearing AR back blocks. Working on both CMS 1500 (Physician Claims) & UB 04 (Hospital Claims) Claim forms. Working on Cerner and E-premise Hospital Billing Tool. Assignment of tasks and helping in understanding user requirements.

associate-field representative

EXL

Full-time•Invalid Date - Invalid Date

Representing level 3 team of British gas to look for accounts, handle meter jobs & Faults in meters to make job easy for field representatives. Working on data that is highly important for client that is British Gas.

Junior Engineer

HCL TECHNOLOGIES

Full-time•Invalid Date - Invalid Date•Noida, Uttar Pradesh

Network connectivity troubleshooting Analysed software, hardware and network systems for various transmission systems. Worked with Routers Provided to BT Customer.

Education

IMT, Ghaziabad

MBA

Data analyst

Jan 2018 - Jan 2020•Grade: 61%

SCTTM, Delhi

BCA

Jan 2012 - Jan 2016•Grade: 67%

National Victor Public School

12th Board

Jan 2012•Grade: 80%

National Victor Public School

10th Board

Jan 2010•Grade: 7.2 CGPA

Skills

US Healthcare RCM
ICD-9
ICD-10
CPT
HCPCS
Billing Guidelines
CMS-1500
UB04
Cerner
E-premise
MyChart
iDocs
Star 24
MedSeries
TPX
R1D
MS Office
Excel
SQL
PowerPoint
Data Analysis
Gap Analysis
Leadership