Bengaluru, Karnataka, India
I have 11+ years of experience in Healthcare industry, Insurance industry, member Benefits and Member services. I have worked for couple of Multi national companies during this tenure. My strengths are ability to work on multiple process, knee to work on new technologies, confident team player, time management, problem solver. Also capable to handle multiple projects.
Supervised a team of 35-40 employees, Transition accounts, New client onboarding, Client satisfaction surveys, monthly insights reports including work summary and client billing, forecast volume and revenue. Forecasted revenue vs Achieved revenue. provide solutions, tracked KPIs, provided feedback, and fostered teamwork to drive performance, boosting efficiency and quality. Build and maintain strong relationships with customers by addressing inquiries, resolving issues, and ensuring satisfaction. Maintain accurate customer records in CRM systems, track interactions, and generate reports to provide actionable insights for business growth. Analyze customer feedback and service trends to identify opportunities for enhancing processes, products, and overall customer experience. Coordinate with internal teams to align on client needs, contractual agreements, and service delivery standards. Proficient in Excel and Google worksheet, streamlining reporting processes with automation. Conducted stakeholder meetings to resolve issues and provide updates, update SOPs and guidelines, and ensure quality outcomes. Conduct team huddles, allocate work effectively, and ensure adherence to turnaround times (TAT) and quality benchmarks. Led complex projects, identified risks, and optimized operations. Strategized and executed plans to meet revenue targets and capacity needs, including hiring and capacity planning.
Led a team of 20-30 employees, driving efficiency through task allocation and timely inventory management. Trained and mentored team members to enhance skills and meet performance benchmarks. Maintained client satisfaction through clear communication and prompt responses. Collaborated with the auditors to eliminate errors and ensure compliance with client regulations. Led a team of 10-15 employees, driving efficiency through task allocation and timely inventory management. Trained and mentored team members to enhance skills and meet performance benchmarks. Maintained client satisfaction through clear communication and prompt responses. Collaborated with the auditors to eliminate errors and ensure compliance with client regulations. Skills: Employee Benefits · Benefits Administration · Enrollments · Claims Management · Team Leadership · Managing Associates · Client Services · Project Management · People Management · Analytical Skills · Communication
Led a team of 15-20 employees, driving efficiency through task allocation and timely inventory management. Trained and mentored team members to enhance skills and meet performance benchmarks. Maintained client satisfaction through clear communication and prompt responses. Collaborated with the auditors to eliminate errors and ensure compliance with client regulations.
Managed a team of 10–15 members, overseeing work allocation, daily deliverables, and performance through regular team huddles. Handled Carrier Payment Audits project and monitored underpayments and overpayments, Support revenue cycle management by monitoring billing accuracy, handling underpayments/overpayments, and assisting with denial management. Implementing corrective actions to safeguard financial outcomes. Specialized in U.S. healthcare insurance operations, including pricing, provider credentialing, and contractual agreements. Led initiatives in revenue cycle management and denials management, streamlining processes to improve efficiency and compliance. Facilitated client calls and management meetings to provide updates, resolve issues, and strengthen stakeholder relationships. Analyze customer feedback and service trends to identify opportunities for enhancing processes, products, and overall customer experience. Ensured adherence to SOPs and quality standards while driving continuous improvement across projects.
Independently managed a project with a team of ten coaching and training junior members while addressing bulk claim issues and implementing resolutions. Took initiatives in the absence of supervisors and consistently achieved production and quality targets.
Managed end‑to‑end claims resolution processes, including dental claims, submissions, and appeals, ensuring compliance with payer requirements. Handled electronic data interchange (EDI) transactions to streamline claims submissions and improve accuracy. Oversaw denial management, addressing insurance denials through root‑cause analysis, corrective actions, and appeals. Conducted insurance calling and AR follow‑up to resolve outstanding claims and accelerate collections. Ensured adherence to HIPAA regulations and maintained confidentiality in all healthcare transactions. Collaborated with providers and payers on insurance pricing, credentialing, and contractual agreements to support smooth operations.