Amit Kalra

Led six different BI teams of 80+ users in predicting and analyzing critical business performance metrics, driving impactful insights that enhanced overall strategic decision-making.

• Developed and analyzed standard and comprehensive reports using Snowflake queries, providing key insights that drove strategic decision-making and optimized operational efficiency.
  
• Designed and implemented dynamic Power BI dashboards displaying critical KPIs and denial progress, enabling stakeholders to spot revenue opportunities and action items, ultimately enhancing strategic decision-making.
  
• Spearheaded in-depth root cause analyses to uncover prevention strategies, successfully reducing revenue leakage by 20%.
  
• Identified opportunities to reduce manual efforts by 30% through the implementation of automations and Power BI, streamlining reporting processes for enhanced efficiency.
• Implemented a daily accuracy tracking system, identifying errors, and corrective actions to enhance overall process health checks.
  
• Monitored and tracked daily performance reports for new hires, showcasing accuracy, productivity, and performance milestones, contributing to enhanced onboarding processes and team efficiency.
  
• Conducted monthly one-on-one meetings with each team member to create personalized action plans, enhancing individual performance, and overall team cohesion.
• Implemented SWOT analyses and personalized development plans, improving employee performance by 25%, and engagement by 30%.
• Facilitated weekly EWS customer calls to address process issues and track progress, resulting in improved alignment between onshore and offshore teams, and a 15% reduction in project delays.
• Elevated team productivity and performance by providing targeted training and coaching, leading to measurable improvements in accuracy and efficiency.
• Conducted daily quality analysis for the offshore team, efficiently coordinating with the India team to address errors and implement necessary updates, while managing all aspects of data quality assessment through careful planning and execution.
• Coordinated and facilitated daily WebEx conference calls with onshore SMEs, effectively gathering resolution updates, and disseminating action-focused reports and meeting minutes to enhance team communication and collaboration.
• Evaluated and analyzed key health insurance contract terms for assigned contracts, ensuring compliance, and identifying opportunities for cost savings.
• Led the seamless transition of new tasks and site implementations, ensuring minimal disruption during maintenance phases, and optimizing operational efficiency.
• Building Knowledge Capability & Training: Process Training in the United States as part of the transition for two months in November-December 2010, successfully cleared Level 1 training on Contract Modeling (U.S. hospitals and U.S. insurance companies' contracts).
• Successfully conducted over 100 training programs for new hires and existing employees, enhancing skills and knowledge, which led to a noticeable improvement in team productivity and morale.
  Developed dynamic bi-weekly, monthly, and quarterly dashboards shared with the onshore team, enhancing visibility into workflow efficiency, resource allocation, quality metrics, and technical performance, leading to timely interventions for any identified issues.
• Compiled and shared weekly site-specific progress reports with U.S. counterparts, highlighting key deliveries, volume trends, and technical challenges, significantly enhancing communication and decision-making efficiency.

• Company Overview: United Health Group is an innovative leader in the Health and well-being industry, serving approximately 70 million Americans through its family of companies. Contributes outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
• Processing of Medical Claims (Inpatient, outpatient, Medicare, Medicaid claims).
• Claim adjudication, Claim verification getting all types of claims processed within the turnaround time.
• Claim adjudication.
• Training Calls.
• Driving knowledge capabilities by providing trainings to new/existing employees.
• Payment verification before release.
• Validating contracts between hospital and Insurance companies.
• Validating Patient Responsibilities – Co pay, Co-insurance, Deductible from Explanation of Benefits, Accounting system.
• Denial Handling.
• Coverage Verification.
• Referral Verification.
• United Health Group is an innovative leader in the Health and well-being industry, serving approximately 70 million Americans through its family of companies. Contributes outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

• Company Overview: Keane World Zen is a US based BPO company which combines onshore process optimization with offshore outsourcing-helping client leverage BPO to reduce costs while transforming their operations for sustainable benefits. It offers Health care, Insurance, Financial & Collection Services to its clients.
• Working in a web-based process in which we receive scanned images of health insurance Claims from the US client (Blue Cross Blue Shield). Involved in adjudicating the claims (HCFA and UB-92) so as to satisfy and meet the standards and emerging needs of the client.
• Coordinating with Team Leader regarding training & procedural issues.
• Claim verification getting all types of claims processed within the turnaround time.
• Processing of Medical Claims (Inpatient, outpatient, Medicare, Medicaid claims).
• Weekly/Monthly Site specific client calls (Client Interaction on WebEx/calls/Emails).
• Maintaining Query Tracker.
• Keane World Zen is a US based BPO company which combines onshore process optimization with offshore outsourcing-helping client leverage BPO to reduce costs while transforming their operations for sustainable benefits. It offers Health care, Insurance, Financial & Collection Services to its clients.