Summary
Overview
Work History
Education
Skills
Timeline
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Padmaja Rao

Summary

Dynamic Healthcare Data Analyst with over 20 years of experience in Revenue Cycle Management (RCM) and healthcare data analytics. I leverage data insights to optimize financial performance, reduce claim denials, and enhance operational efficiency across diverse health systems. With a proven track record of translating complex data into actionable strategies, I effectively streamline operations and promote sustainable revenue growth. My expertise includes end-to-end RCM processes, data visualization tools such as SQL, Tableau, and Power BI, and ensuring regulatory compliance. As an EPIC Superuser, I have successfully led product launches at hospitals and providers, optimizing workflows while driving measurable revenue growth and cost reduction improvements.

Overview

18
18
years of professional experience

Work History

Sr. Operations | Revenue Cycle Optimization Analyst

Jorie AI
07.2024 - Current
  • Utilized advanced analytics to track financial outcomes and optimize revenue for global clients, ensuring HIPAA compliance
  • Achieved a 30% reduction in claim denials and a 15% increase in recovery rates by analyzing root causes and implementing data-driven strategies
  • Collaborated across teams to align revenue cycle management processes with regulatory requirements.

Sr. RCM Client Success Manager

Jorie AI
11.2021 - 06.2024
  • Led data analytics initiatives that enhanced revenue recovery and operational efficiency for clients
  • Reduced registration denials by 55%, resulting in a 20% revenue increase over two years
  • Conducted trend analysis to optimize pricing and A/R metrics, helping clients meet financial targets.

Insurance Resolution Specialist

Trinity Health System LUHS
05.2019 - 10.2021
  • Leveraged data analytics to identify denial trends and implement corrective measures, boosting payment recovery rates
  • Collaborated with senior leadership to deliver insights that enhanced revenue cycle performance.

Accounts Receivables Manager

GI Partners of IL, LLC, RCM
02.2007 - 09.2018
  • Achieved a 98% clean claim submission rate, reducing denial rates by 15% above industry benchmarks
  • Streamlined workflows using trend data, resulting in a 20% reduction in operational costs and a 15% increase in cash collections.

Education

Bachelor of Science (BS) - Health Science and Business

Benedictine University

<ul><li>Certified Revenue Cycle Representative (CRCR) – Health Financial Management Association (HFMA)</li><li>Certificate of Completion as Certified Physician Practice Manager (CPPM) -American Association of Professional Coders (AAPC)</li><li>Certified EPIC Superuser in Resolute</li><li>Certificate in Coding and Reimbursement Solutions - McVey Associates</li></ul> -

Skills

  • Root Cause Analysis
  • Process enhancement
  • Trend forecasting
  • Workflow Analysis
  • Documentation And Reporting
  • Data Analytics & Reporting
  • Proficient in SQL, Tableau, and Power BI for data visualization and revenue forecasting
  • Expertise in analyzing healthcare data to optimize financial performance and operational efficiency
  • Strong experience in utilizing predictive analytics to drive process improvements
  • Healthcare Regulations & Compliance
  • In-depth knowledge of HIPAA regulations, payer policies, and industry standards
  • Ensures compliance with healthcare laws across all RCM processes and data reporting
  • Skilled in adhering to payer-specific requirements to minimize denials and optimize revenue
  • Revenue Cycle Management (RCM)
  • Extensive experience in full-cycle RCM, including denials management and claims processing
  • Proven track record in reducing claim denials and improving days in A/R by leveraging analytics
  • Expertise in utilizing data to enhance clean claim rates and optimize reimbursement strategies
  • Financial Performance Optimization
  • Adept at reducing bad debt and improving KPIs such as A/R days and clean claim rates
  • Utilizes trend analysis to identify cost-saving opportunities and optimize revenue recovery
  • Skilled in developing and implementing strategic initiatives to enhance revenue growth
  • EHR Systems Expertise
  • Certified EPIC Superuser in Resolute with expertise in multiple EHR systems (eClinical Works, Athena, Modmed)
  • Leveraged EHR data to reduce claim denials and improve billing accuracy
  • Experienced in training teams on EHR systems and RCM processes
  • Process Improvement & Team Leadership
  • Proven ability to streamline workflows and reduce operational costs using data-driven approaches
  • Strong cross-functional leadership skills, collaborating with clinical, administrative, and financial teams
  • Adept at aligning process improvements with regulatory requirements and financial goals
  • Client Relationship Management
  • Skilled in building and maintaining strong client relationships by aligning data insights with financial objectives
  • Collaborates with stakeholders to drive performance improvements and optimize financial outcomes

Timeline

Sr. Operations | Revenue Cycle Optimization Analyst

Jorie AI
07.2024 - Current

Sr. RCM Client Success Manager

Jorie AI
11.2021 - 06.2024

Insurance Resolution Specialist

Trinity Health System LUHS
05.2019 - 10.2021

Accounts Receivables Manager

GI Partners of IL, LLC, RCM
02.2007 - 09.2018

<ul><li>Certified Revenue Cycle Representative (CRCR) – Health Financial Management Association (HFMA)</li><li>Certificate of Completion as Certified Physician Practice Manager (CPPM) -American Association of Professional Coders (AAPC)</li><li>Certified EPIC Superuser in Resolute</li><li>Certificate in Coding and Reimbursement Solutions - McVey Associates</li></ul> -

Bachelor of Science (BS) - Health Science and Business

Benedictine University

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Padmaja Rao