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Team
A division of Managed Outsource Solutions (MOS), Outsource Strategies International (OSI) is a professional medical billing company providing tailored revenue cycle management (RCM) solutions for the healthcare and dental industries. Our managerial team comprising clinical and management specialists have several years of hands-on experience in the industry.

Our team leaders are industry veterans with a deep understanding of the complexities involved in medical and dental revenue cycle management. Led by these seasoned professionals with proven track records, our team navigates the intricate world of healthcare reimbursement with expertise and efficiency.

Our comprehensive RCM solutions include medical billing, coding, claims management, and revenue optimization. We use advanced technology and industry expertise to navigate the complexities of healthcare reimbursement, enabling you to focus on delivering exceptional patient care without the burden of administrative challenges. Our AAPC-certified medical coders and billing specialists have worked with practically every specialty and have the expertise to efficiently manage your revenue cycle.

Our medical and dental RCM specialists are knowledgeable in the unique requirements of government and commercial insurance companies. This allows them to efficiently manage the revenue cycle for our clients and ensure optimal reimbursement.

Team Works
Our CPC-certified medical coders have a strong understanding of medical coding for all specialties and stay up-to-date with coding changes, payer-specific documentation requirements, and state and federal regulations. They regularly publish articles and blogs on medical billing and coding. Their expertise on various topics has been featured various publications including BC Advantage Magazine, the highly acclaimed, largest CEU-approved online resource for medical office professionals.

Our team has deep expertise in navigating the complexities of medical and dental insurance verification and authorization. From confirming patient eligibility to securing necessary prior authorizations, they leverage their extensive knowledge to guide clients through the intricacies of payer requirements. They provide real-time verifications before services are provided. By staying abreast of evolving insurance policies and regulations and communicating effectively with payers, our experts are able to reduce claim denials and maximize our clients’ financial performance.

All of our services are delivered by US-based professionals supported by on-shore and offshore departments. We work in all 50 states. Our team has expertise in almost all types of billing software and manages our clients’ revenue cycle with no disruption to their systems and workflow.

Bob Kruse

Co-Founder

With previous experience as engineer and hospital CEO, Bob and his wife began entrepreneuring in 1993 with Kruse & Associates; recruiting and placing healthcare professionals. In 2002, as management and ownership of Kruse & Associates was being transferred to long-term employees, Rajeev called and Managed Outsource Solutions was spun off.

With B.S. degrees in Engineering and Business, and an M.S. degree in Health/Business Administration, his experience in healthcare management and as an entrepreneur provides valuable vision and long-term planning as well as management to the OSI team.
Bob resides in Broken Arrow, Oklahoma with his wife; and is often either preparing for or experiencing visits from several children and grandchildren. When not giving tractor rides, he can be found cutting wood or building (another) deck.

Rajeev Rajagopal

President
Rajeev immigrated to the United States from India in the mid 90s with an education in physical therapy and computer science, and began working as a physical therapist. He later started a business as a healthcare business consultant. Having worked in several rehabilitation clinics, Rajeev has learned the importance of good medical records for effectively handling billing and liability issues. After experiencing a clinic saving money by outsourcing, he called Bob and “the rest is history”.

He manages the day-to-day operations of OSI from NY. With an interest in information technology, Rajeev has guided OSI to extensive use of digital technology and the internet that benefits OSI as well as its clients.

Rajeev resides in Long Island, NY. When not working on OSI projects, Rajeev is doing things with his active son, or spending a little time on the badminton court.

Julie Clements

Vice President of Operations: St. Paul, MN
With some background in the healthcare staffing arena, as well as 6 years as Director of Sales and Marketing at a 4 star resort, Julie joined OSI in March of 2008. With her fingers very much into sales and marketing, Julie has moved into a support role as well, brought about from exceptional customer relations skills.

Julie was instrumental in the creation of the medical record review division (and new web site); and works in sales and support for this as well.

Julie lives with her husband and three children in Eagle, St. Paul, Minnesota; where after a busy day with OSI, she changes hats to “soccer mom and coach.” Incidentally, she occasionally dons a uniform herself in a recreational league, after playing varsity soccer in high school.

Natalie Tornese

CPC: Director of Revenue Cycle Management: Healthcare Division
Natalie joined MOS’s Revenue Cycle Management Division and brings twenty five years of hands on management experience to the company. Starting as an EMT in New York City, she has held positions of progressive responsibility throughout her career – serving a diverse range of practices and specialties. Her experience includes all aspects of revenue cycle management, including multiple leadership roles and management of multiple accounts. She also holds a CPC certification by the American Academy of Professional Coders (AAPC). She presently manages Medical Billing, Medical Coding, Verification and Authorization services for MOS.

Currently residing in New Jersey, Natalie’s interests include medieval and Renaissance art and history, spending time with her family and entertaining.

Meghann Drella

CPC: Senior Solutions Manager: Practice and Revenue Cycle Management, Healthcare Division
Meghann has a formal education in Medical Coding and Billing and over 12 years of hands on experience in the field. She is CPC certified with the American Academy of Professional Coders (AAPC). She has a strong understanding of ICD-10-CM and CPT requirements and procedures, and regularly attends continuing education classes to stay up to date with any changes. Meghann has a great rapport with all of her clients, and has a unique ability to handle each Client’s account with the attention needed for success. She is presently involved in Medical Billing, Medical Coding, Verification and Authorization services for MOS.

Currently residing in New Jersey., Meghann’s interests include Music, Sports (she is a big NY Giants fan) and spending time with family.

Amber Darst

CPC: Solutions Manager: Practice and Revenue Cycle Management: Healthcare Division

Hired for her dental expertise, Amber brings a wealth of knowledge and understanding of the dental revenue cycle management (RCM) services to MOS. She is CPC certified by the American Academy of Professional Coders (AAPC). Having worked as a dental insurance coordinator, office manager, and a fill-in dental assistant, she knows how important it is to make sure everything is noted, coded, and billed correctly to ensure top returns in Accounts Receivables. In addition to this experience she brings to the MOS team, Amber’s true foundation is establishing and maintaining a high level of personal relationships between herself and her clients. This knowledge and relationship building is seen in her ability to help clients have a smooth transition to MOS’s outsourcing services. Amber currently resides in West Virginia. She enjoys spending time with family and has a heart of wanderlust.

Loralee Kapp

CPC: Solutions Manager: Practice and Revenue Cycle Management: Healthcare Division

Loralee joined MOS’ Revenue Cycle Management Division in October 2021. She has a degree in Health Information Management and Technologies, with over five years of experience in medical coding and Health Information Management practices. She is CPC certified by the American Academy of Professional Coders (AAPC). She has worked in both physical therapy and skilled nursing, allowing for a wide array of experience in multiple specialties. Loralee strives to have an open and honest relationship and foster a positive work environment.

She currently resides in Pocatello Idaho with her husband, baby girl, and Goldendoodle. She loves hosting game nights and spending time with her family.

Jan Merrifield

Senior Solutions Manager: Transcription, Medical Record Review, Data Conversion
Jan joined the MOS team in early 2011, strengthening both our Marketing and Support. With a BS in Education, and then adding RN to her credentials, her experience ranges from surgical and home health RN to ownership of a medical equipment company. Her expertise in customer service, marketing, and clinical knowledge along with her positive and bubbly personality, make her a welcome addition to the MOS team.

Jan is a third generation OU grad and resides in Tulsa, OK. She is actively involved in non-profit agencies. Her sons, dancing, singing, and entertaining fill her with joy.

Cassidy Case

Solutions Manager
Cassidy joined MOS in July 2023. She graduated from Idaho State University in August 2021 with a Bachelors in Health Science and Associate of Applied Science as a Physical Therapy Assistant. Utilizing her experience with direct patient care, Cassidy strives to connect and effectively communicate with her clients.

Cassidy currently resides in Pocatello, ID with her husband, son, and kitten Sylvie.