Ananthula Mahanth
Hyderabad
Summary
A seasoned professional with 5 years 9 months of experience in Project management and leadership with immense knowledge in US Healthcare. Analytical professional with technical knowledge and critical thinking skills to thrive in data-driven environments. Tackles challenges with positivity and drive to overcome. Works great alone or with others and consistently exceeds expectations. Experienced Subject matter in US healthcare Payer side. Holder of Computer science from Meerut University and well-known professional with 5 years 9 months in Healthcare KPO industry for claims adjudication. Effective contributor to ongoing systems and procedural development dedicated to providing expert guidance towards incessant growth.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Team Leader - Operations
Teleperformace
Mumbai
04.2024 - Current
- Claims and Insurance Process Team Leader
- Led and mentored a team of claims and insurance professionals.
- Managed team schedules and organizational expectations.
- Provided upward feedback regarding the status of claims, communicating regularly with supervisors and managers.
- Implemented people and process improvements to enhance efficiency and customer satisfaction.
- Monitored teams investigating, evaluating, and resolving claims in compliance with Host Guarantee Terms of Service using a multichannel customer support environment.
- Ensured timely and accurate processing of claims in compliance with industry standards and company policies.
- Handled inbound and outbound tickets/emails, calls, and case work through designated inboxes.
- Initiated, investigated, and resolved cases involving complex damage, liability claims, potential fraud, or brand risk, verifying facts, and determining resolutions based on internal policies.
- Stayed updated on industry regulations and ensured team compliance.
- Utilized data to make informed decisions and implemented process enhancements.
- Set up mechanisms to understand key trends and issues faced by ambassadors, including building an audit mechanism to review performance.
- Mastered knowledge of company policies and procedures, becoming an expert in claims verification, payment processing, dispute resolution, and fraud detection.
- Determined compensation and validity of claims, identified possible claim risks, and liaised with other departments to de-escalate active threads.
- Maintained high levels of confidentiality while performing investigations.
- Successfully led a team to achieve high efficiency and accuracy in claims processing.
- Enhanced customer satisfaction through continuous process improvements and effective team leadership.
- Maintained compliance with industry standards and company policies.
Team Leader - Operations
Firstsource Solutions
Vijayawada
06.2023 - 11.2023
- Currently managing a team of 25 FTEs and in complete charge of their performance and other factors.
- Supervised operations staff and kept employees compliant with company policies and procedures.
- Managed leave requests and absences and arranged covers to facilitate smooth flow of operations.
- Introduced new methods, practices, and systems to reduce turnaround time.
- Conducted training and mentored team members to promote productivity and commitment to friendly service.
- Communicated KPIs outlined in annual plan to inform employees of expectations and Deliverables.
Team Leader - Operations
Wipro DO&P
Hyderabad
09.2021 - 02.2023
- Handling a team of 24 agents - Performance Management and Leave Management.
- Grooming team members.
- Work assignment and work completion to maintain the TAT.
- Handling escalations and responding on time.
- Looking after internal and external quality.
- Live monitoring to identify the barriers.
- Sharing Quality updates and agenda with the team.
- Monitor the performance of the associates & coach them, if required.
- Was a part of Lean Project to bring down the number of Aged inventory which is a biggest challenge these days.
- Sharing the Inventory status and handling Client Calibration meet Regarding Market DWOH.
Subject Matter Expert
Wipro Limted
Hyderabad
03.2021 - 09.2021
- Conducted refresher training for On-floor associates and on the Quality tools.
- Compiling Training Data and MIS and maintain/publish daily.
- Coordination with Operations.
- Retro auditing all the claims/Line items/Charts which was worked by the associates.
- Conducting regular retro audits of representative claim work for accuracy and quality to identify the knowledge gap.
- Providing direction to client leads on identifying a trend and pattern on claims/Line items/Charts audit corrections and resolution.
- Preparing and analyzing reports of audit review and performance issues with a focus on identifying trends, instituting continuous quality improvement initiatives, and identifying and providing ongoing training opportunities for representatives.
- Individual feedback and conduct a briefing session at the start of the shift.
- Understand Client requirements and specifications of the project.
- TNA based on audit findings and Process specifications.
- Ensure that the deliverables to the client adhere to quality standards.
- Upgrading the product & Process Training content periodically.
Senior Claims Associate
Wipro DO&P
Hyderabad
01.2019 - 03.2021
- Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
- Ensure all HIPPA regulations are followed in the creation and release of all confidential records.
- Coordinate vendor referrals for additional investigation and/or litigation management.
- Checking all the data mapped correctly from Claim form to Electronic health records.
- Uploading the Mail back claims to the Mailroom.
- Ensuring all the fields in claim data captured correctly in the EHR.
Education
BSC - Computer Science
BSC Computers
India 02.2016 - 01/2019
Navavignana Bharathi Junior college
Warangal, ANDHRA PRADESH, INEkashila high School
Warangal, ANDHRA PRADESH, INSkills
- Revenue cycle management
- Project management
- Microsoft Excel
- Microsoft Word
- Microsoft PowerPoint
- C
- C
- Python
- Leadership
- Friendly attitude
- Positive attitude
- Analytical
- Problem resolution
- Relationship building
- Communication
- Troubleshooting
- Customer service
- Critical thinking
- Communication skills
- US healthcare
- Management
- Organisational skills
Certification
- Introduction to Robotics and automation, 05/01/22, Simply i Learn, 207444
- Excel VBA and Macro, 03/01/21, Udemy, http://ude.my/UC-eba74de0-1538-49cf-ad52-e04a7202e55f
- Fundamentals of Communication DCFS0143, 03/01/21, Deakin University, DCFS0143
- Advanced Java, 11/01/20, Udemy, http://ude.my/UC-4065a02b-6655-44ed-b036-4413954bc219
- Introduction to Python, 08/01/20, Great Learning, https://olympus1.greatlearning.in/course_certificate/WOJKEWSI
Languages
- English, Fluent
- Telugu, Native
- Hindi, Intermediate
Languages
English
Advanced
C1
Telugu
Proficient
C2
Hindi
Upper Intermediate
B2
Timeline
Team Leader - Operations
Teleperformace
04.2024 - Current
Team Leader - Operations
Firstsource Solutions
06.2023 - 11.2023
Team Leader - Operations
Wipro DO&P
09.2021 - 02.2023
Subject Matter Expert
Wipro Limted
03.2021 - 09.2021
Senior Claims Associate
Wipro DO&P
01.2019 - 03.2021
BSC - Computer Science
BSC Computers
02.2016 - 01/2019
Navavignana Bharathi Junior college
Ekashila high School