Suresh Maheshwaram
Fort Wayne,USA
Summary
Detail-oriented Healthcare Correspondence Specialist with over 3.5 years of experience in Revenue Cycle Management (RCM), specializing in secondary claims, EOB reconciliation, and insurance appeals processing. Adept at preparing and mailing claims and appeals, following up with payers on denials and statuses, and maintaining HIPAA-compliant documentation workflows. Known for strong attention to detail, organizational efficiency, and effective collaboration across departments.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Senior Analyst
R1 RCM
08.2022 - 01.2023
- Processed and submitted secondary insurance claims, ensuring complete documentation and timely mailing per payer guidelines.
- Matched claims with primary EOBs, reducing denials and improving claim resolution efficiency.
- Drafted and mailed appeal letters with supporting documentation, resulting in a 70% overturn rate.
- Called insurance companies to obtain detailed denial reasons, clarify appeal timelines, and verify claim statuses.
- Followed up on outstanding claims and appealed cases, escalating issues to payers when needed to ensure resolution.
- Maintained correspondence logs and filing systems for outgoing claims and appeals.
- Collaborated with billing teams to resolve claim rejections and manage documentation integrity.
Senior Analyst
Optum Global Solutions (UHG)
12.2020 - 07.2022
- Prepared and mailed insurance appeals using CPR+, adhering to strict timelines and payer formats.
- Contacted insurance payers (Medicare, Medicaid, PPOs, HMOs) to verify claim status and obtain information on denial codes and appeal windows.
- Managed incoming corporate mail related to billing and claims, distributing items accurately to departments.
- Tracked all outgoing correspondence and appeal submissions using internal systems.
- Followed HIPAA protocols when handling confidential claim documents and EOBs.
- Reconciled claims and appeals using EDI data (837, 835, 277) and clearinghouse tools.
Junior Analyst
Hinduja Global Solutions
12.2019 - 12.2020
- Handled the preparation and mailing of corrected claims and appeal packets.
- Matched EOBs with denied claims and organized documentation for efficient appeals submission.
- Called payers regularly to check the status of submitted claims and appealed cases, and to resolve rejection issues.
- Maintained filing logs and audit-ready documentation for claims processing.
- Processed incoming insurance-related correspondence and routed it to appropriate teams.
- Ensured HIPAA-compliant handling of all printed and mailed materials.
Education
MBA - Business Analytics
Indiana Institute of Technology
Fort Wayne, IN11.2024
Skills
- Epic
- CPR
- NEXT
- Waystar
- Change Healthcare
- Athena
- SQL
- Power BI
- Microsoft Excel
- ANSI X12 EDI
- CMS-1500
- UB-04
- ICD-10
- CPT-4
- HCPCS
- Claim Scrubbing
- 837/835/277 EDI Transactions
Certification
- Healthcare IT Support – Coursera | 2025
- SQL for Data Science – University of California, Davis | 2024
- Excel Skills for Business – Macquarie University | 2024
- Google Ads Search Certification – Google | 2024
- Google Analytics Certification – Google | 2025
Timeline
Senior Analyst
R1 RCM
08.2022 - 01.2023
Senior Analyst
Optum Global Solutions (UHG)
12.2020 - 07.2022
Junior Analyst
Hinduja Global Solutions
12.2019 - 12.2020
MBA - Business Analytics
Indiana Institute of Technology
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