KAUSHAL PARIKH email: kaushalparikh.mha@gmail.com

43540 Hoptree Dr, Sterling Heights, MI 48314 (586)646-0328

EDUCATION: University of Phoenix Masters in Health Care Administration / Informatics (Mar 2015) GPA: 3.9 Lawrence Tech University Lean Six Sigma Black Belt Certification (Nov 2015) Achieved University of Michigan and Blue Cross Blue Shield Blue Care Network of Michigan Lean for Clinical Redesign (Mar 2015) 30 Hours Utica Community Schools Certification in Medical Billing & Coding (Dec 2010) GPA: 4.0

SUMMARY: Health Care Operation Manager specializing in transformational leadership with capacity to grow with the organizations mission, vision, and values. With several years of experience increasing operational effectiveness by conducting and managing coordinated team effort to accomplish set goals, while improving patient experience. Extensive knowledge in reading and interpreting medical terminology utilizing ICD 9, ICD 10, CPT 4 coding. Strong understanding of Medicaid, Medicare, commercial/ managed care, Blue Cross Blue Shield, payer billing and reimbursement processes.

TECHNICAL SKILLS:

Advanced Microsoft Excel, Word, Powerpoint, Outlook, ICD-9, CPT Coding, IDX billing system, EMR, LINKS, CIS, Outlook, Other Certification: Certified Application Counselor

PROFESSIONAL EXPERIENCE:

Healthcare Operation Manager, October 2014 – Present Wayne State University Physician Group

Analyze and identify improvement opportunities for management of day to day operations of multiple clinics within the organization to help improve patient experience.

o Manage provider education regarding billing and meeting the meaningful use criteria o Facilitate new processes and implementation of new technology by creating process workflow

and standardization within WSUPG

Applying and promoting the use of lean improvement processes which include value streaming, 5S, cause and effect diagram, 5 why diagram, SWOT analysis, and PDCA cycle

Direct and support the front desk operations to improve billing and revenue cycle o Manage front desk staff who's responsibilities include insurance verification, charge entry,

arriving, and checking out patients, and many of other functions that help improve revenue cycle

Financial Healthcare Counselor, April 2013 – October 2014 Wayne State University Physician Group

Managed, maintained, and resolved large balance accounts (balances range from $25,000+)

Managed average of over 500 patients accounts per month

Coordinated Insurance verification, rejection, and billing by working A/R reports

Assisted financially challenged and self-pay patients o Obtained State funded insurance (Medicaid) or the ACA to help reduce patient balance o Conducted PowerPoint presentation and communicated with the public re: Affordable Care Act o Analyzed, evaluated, and presented financial findings on patient regarding charity care o Established and monitored budgets plans on balance of $100 or more to collect monthly

payments

Medical Office Associate, April 2012 – April 2013 Wayne State University Physicians Group

Managed and collected correct demographics and insurance information in IDX and EMR

Communicated with providers re: chart completion and missing charges and patient communication

Conducted billing and charge entry according to the billing level and diagnosis identified by the provider

Utilized HIPPA compliance principles when handling Patient Health Information re: transfer or coordination of care

Assisted patients in obtaining referrals, insurance authorizations, and signing up for patient portals

Coding and Billing Specialist April 2011 - July 2011 S.A Patel MD, Internal Medicine

Provide and apply coding principles using ICD 9 CM and CPT

Past and current Accounts Receivables, includes rebilling denials, and dealing directly with insurance companies for payments and posting electronic checks and patient payments

Acquiring prior authorization for procedures with insurance companies