Learning new and innovative tools and inhance skills based on Automation Artificial Intelligence and Data analysis
Ashish Kumar
Team Lead
Greater Noida
Summary
Having 13+ years of experience in US Healthcare in different domains- Account Receivable, Billing, Claims Adjudication and Appeals. Also worked for Insurance Client Services and Broker Services and having hands on experience of working and handling new transitions. I have 5 years of experience in team handling and currently working as Team Lead.
Experienced with leading teams to achieve project goals through effective management and strategic planning. Utilizes strong organizational and communication skills to foster collaboration and drive performance. Track record of successfully overseeing project execution and adapting to dynamic work environments.
Overview
13
13
years of professional experience
2
2
Languages
Work History
Team Lead
Pacific BPO (Access Healthcare)
09.2024 - Current
- Handling project with 19 resources and managing team to achieve production and quality SLA.
- Monitoring production and quality of the team as well as individual team members.
- Sharing shrinkage, filing rebuttals, preparing production and quality reports.
- Sharing updates received from client and resolving team’s queries.
- Sharing production and quality reports with RCA and rebuttals on feedback.
- Creating PowerPoint presentation for weekly meeting with top management.
- Handling client calls on weekly basis and sharing roadmap and plan of action.
Process Lead
Wellcove (CHCS Services)
08.2022 - Current
- Handling LOB with 15 resources and managing team to achieve production and quality SLA.
- Leading Team meeting and taking EBT (Error Based Training).
- Providing floor support and resolve team’s queries.
- Sharing production and quality reports with RCA and rebuttals to client.
- Assigning workflow based on ageing and TAT.
- Creating dashboard and PowerPoint presentation in weekly client meeting.
Subject Matter Expert
Capgemini India Technology Services Ltd
08.2017 - 08.2022
- Handling LOB and managing a team with 11 resources.
- Taking download from client and sharing heads up with team.
- Providing trainings to new resources and support them to achieve ramp up goals.
- Working on client email box to provide email assistance to policy holders.
- Creating SOP, MOM, Training plan and performance tracker.
- Making reports of production, quality, billing data and sharing with client on daily basis.
- Assigning workflow based on ageing, monitoring team quality and providing floor assistance.
Quality Auditor
IGATE Global Solutions Ltd
08.2013 - 07.2017
- Working as Quality Auditor and auditing of Insurance payment EOB processed by claims team.
- Providing feedback to the processing team and share internal quality data with team.
- Balancing the check paid by Insurance to provider.
Account Receivable
Porteck India Pvt Ltd.
05.2012 - 07.2013
- Making calls to the insurance companies to take claim status.
- Checking claim status on Insurance website and working on denial batches.
- Achieving production and quality targets on daily basis.
- Working on different insurance’s denials and creating appeals to reprocess.
- Worked on refunds, project-based adjustments, offset and write-off cases.
Education
Bachelor of Arts -
Lucknow University
Intermediate - undefined
U.P. Board
High school - undefined
U.P. Board
Skills
Accomplishments
- Value Creator award in Q3, 2021 for creating Performance Management Tool
- Rising Star award in Q2, 2021 for contribution in service delivery.
- Extra Miles award in 2020 for Out of the Box Idea.
- Rising Star award in 2019 for contributing in transition of two new LOBs.
- Employee of the year award in 2018 for contribution in new transitions.
- Pat on the back from client for creating IQT (Internal Quality Tool) in 2016.
Personal Information
- Date of Birth: 09/02/87
- Nationality: Indian
- Marital Status: Married
Disclaimer
I Ashish Kumar hereby declare that all the information provided by me is very true and best to my knowledge.
Applications And Tools
- Emdeon
- IQT
- Sales Force
- DMS (Distributor Management System)
- Boxi
- Star (Agency, GWEW)
- Compass
- QPS
Interests
Timeline
Team Lead
Pacific BPO (Access Healthcare)
09.2024 - Current
Process Lead
Wellcove (CHCS Services)
08.2022 - Current
Subject Matter Expert
Capgemini India Technology Services Ltd
08.2017 - 08.2022
Quality Auditor
IGATE Global Solutions Ltd
08.2013 - 07.2017
Account Receivable
Porteck India Pvt Ltd.
05.2012 - 07.2013
Intermediate - undefined
U.P. Board
High school - undefined
U.P. Board
Bachelor of Arts -
Lucknow University
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