Ram Vsa

Results-driven Healthcare Revenue Cycle Management (RCM) Professional with 5+ years of experience in Eligibility Verification, Benefits Verification, Prior Authorization, and Insurance Validation for US healthcare providers. Skilled in verifying patient insurance coverage, reviewing benefits, obtaining prior authorizations, and coordinating with insurance representatives to ensure accurate claim processing and reduced denials. Strong knowledge of Commercial Insurance, Medicare, Medicaid, HIPAA compliance, and payer guidelines.

Eligibility Verification & Prior Authorization Specialist at Hamly Business Solutions (2024-10 – 2026-05)

• Verified insurance eligibility, benefits, and authorization requirements.
• Submitted and followed up on prior authorization requests through portals and calls.
• Coordinated with providers and insurance representatives to reduce claim denials.
• Maintained accurate documentation in EMR systems.
• Ensured HIPAA compliance and payer guideline adherence.

Eligibility & Benefits Verification Specialist at Guidehouse India Pvt Ltd (2022-08 – 2024-09)

• Verified insurance eligibility and active/inactive policy status.
• Reviewed co-pay, deductible, and coverage details.
• Updated patient demographic and insurance information accurately.
• Reduced payment delays through accurate verification processes.

Accounts Receivable Executive – Eligibility & Benefits Verification at Omega Healthcare Management Services Pvt Ltd (2019-11 – 2022-02)

• Performed insurance eligibility and benefits verification.
• Handled outbound calls regarding claims and coverage validation.
• Supported revenue cycle operations through accurate insurance verification.

Sales Executive at BrainGroom India Pvt Ltd (2017-06 – 2019-06)

• Conducted market research and customer interactions.
• Handled client follow-ups and sales coordination.

Bachelor of Engineering in Computer Science Engineering – J.J. College of Engineering and Technology (2017)