Aniket Mavale
Pune
Summary
Ambitious-driven operations leader with expertise in client coordination, process improvement, and strategic planning. Proven ability to enhance workflow efficiency and ensure compliance, contributing to increased client satisfaction and operational excellence. Detail-oriented professional known for strong conflict resolution and quality assurance skills in operations management. Experienced in conducting audits and implementing process enhancements, driving compliance and client deliverables. Committed to fostering cross-functional collaboration to achieve organizational goals.
Overview
5
5
years of professional experience
Work History
Team Lead - Operations
AMI - AM INFOWEB
Pune
08.2023 - Current
- Team Leadership & Supervision: Manage and guide a team of operations associates, ensuring timely retrieval and processing of records to support revenue cycle functions.
- Process Management: Oversee the end-to-end workflow for record retrieval, verification, and documentation with accuracy and compliance.
- Quality Assurance: Monitor output quality, conduct audits, and implement corrective actions to minimize errors and delays.
- Client Coordination: Act as a bridge between clients, vendors, and internal teams to ensure smooth communication and service delivery.
- Performance Tracking: Set KPIs, track productivity, and provide feedback to enhance individual and team efficiency.
- Compliance & Security: Ensure adherence to HIPAA and other regulatory guidelines in handling confidential medical and legal records.
- Problem Solving: Handle escalations, resolve operational bottlenecks, and implement process improvements for higher efficiency.
- Training and Development: Conduct training sessions for new joiners, and ongoing coaching for team members to keep up with evolving processes.
- Workflow Optimization: Identify areas of improvement in record retrieval and RCM processes to reduce turnaround time, and improve client satisfaction.
- Reporting & Analytics: Prepare and present daily, weekly, and monthly reports on team performance, SLAs, and client deliverables.
Quality Analyst
AMI - AM INFOWEB
Pune
08.2022 - Current
- Audit & Compliance Oversight: Conduct regular audits on record retrieval and RCM processes to ensure compliance with HIPAA and company guidelines.
- Quality Monitoring: Review team outputs (records, documentation, claim submissions) to identify errors, gaps, or non-compliance issues.
- Process Accuracy: Verify that medical, legal, and financial records are retrieved, documented, and processed correctly, with zero data loss.
- Error Analysis and RCA: Perform root cause analysis for recurring errors, and recommend preventive actions to minimize defects.
- Performance Metrics: Track quality KPIs such as accuracy rate, error trends, SLA adherence, and provide detailed reports to management.
- Training and Feedback: Provide constructive feedback and refresher trainings to operations staff to improve quality and compliance standards.
- Client Deliverables Assurance: Ensure all client-specific quality expectations are met before submission, improving trust and client satisfaction.
- Documentation Standards: Maintain standardized documentation and checklists to streamline QA checks.
- Collaboration with Operations: Partner with team leads and managers to align quality goals with operational targets.
- Continuous Improvement: Recommend and implement process enhancements, automation opportunities, or best practices to raise quality benchmarks.
Case Processing Executives
AMI - AM INFOWEB
Pune
08.2020 - 08.2022
- Case Handling (Subpoena and Authorization Requests): Process legal requests for medical records, ensuring compliance with subpoenas, authorizations, and client requirements.
- HIPAA & Compliance Adherence: Strictly follow HIPAA and other regulatory guidelines to maintain the confidentiality and security of sensitive patient data.
- Record Retrieval Coordination: Liaise with healthcare providers, attorneys, and clients to request, follow up, and secure accurate, complete medical records.
- Documentation and Validation: Review legal requests for completeness, validate authorization forms, and ensure correct documentation before processing.
- Turnaround Time Management: Process cases within established SLAs, ensuring timely delivery of records to attorneys, courts, and clients.
- Quality Assurance Support: Ensure records retrieved are accurate, properly formatted, and meet both legal and client-specific requirements.
- Client communication: Provide case updates and clarifications to attorneys, law firms, and clients regarding the status of record requests.
- Escalation Handling: Address discrepancies, missing records, or legal objections with professionalism and accuracy.
- Workflow & Case Tracking: Maintain case logs, update internal systems, and track status for reporting and compliance purposes.
- Cross-Functional Collaboration: Work closely with QA teams, team leads, and compliance officers to uphold service standards.
Education
BBA - Commerce
DY Patil College
Pune07-2019
High School Diploma -
SSPMS
Pune05-2014
Skills
- Client communication and coordination
- Conflict resolution & Employee evaluation
- Process improvement and Product management
- Strategic planning & Risk management
- Operations management
- Cross-functional collaboration
- Workflow optimization & Quality assurance
- Effective communication & Client coordination
- Performance tracking & Audit oversight
- Team leadership
Affiliations
- Ambitious sports driven individual - football, swimming
- Calisthenics: fitness and modeling
- Cookery - Indo-Western Cuisines
Timeline
Team Lead - Operations
AMI - AM INFOWEB
08.2023 - Current
Quality Analyst
AMI - AM INFOWEB
08.2022 - Current
Case Processing Executives
AMI - AM INFOWEB
08.2020 - 08.2022
BBA - Commerce
DY Patil College
High School Diploma -
SSPMS