Ashokkumar Muthiah
Tiruppur
Summary
Seeking a challenging environment that encourages continuous learning, creative and stimulates personal and professional growth.
Overview
12
12
years of professional experience
Work History
Team Lead Role
NTT DATA
05.2018 - 12.2024
- Company Overview: US Healthcare Claims Adjudications.
- Working with US based health insurance Payer/Provider.
- Primary task handling people management with 40 associates and archive target & Quality.Maintain Associate’s production and quality report and daily meeting schedule to discuss today Inflow plan and yesterday production output with Leadership.
- Streamlined and monitored quality programs to alleviate overdue compliance activities.
- Handling with automation process for BOT run for reduce the inventory volume with 100% quality with report to Leadership management for Cost reduction.
- Created a Internal BOT Tool in few high priority category for Internal Level Audit to find a Error.
- Create a BRD document based on high volume category and run the claim by using Automation.dditional support to Process Training with Weekly refresher training conduct and update Client process with Assessment for Knowledge Check by Weekly wise.
- New batch associate take care of all training & Access activity & ramup with live production.
- Responsibility to Handling Pend Management and High Priority Aged claims daily basic assign to team members and complete for Met the TAT & SLA.
- Each month create Team Production report & IRP (Inventory Reduction Plan) for discuss with leadership to analysis team performance.
- Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
- Working and Supporting to PDM Process (Provider Data Management) – Creating a Supplier, Practitioner with Role and Mapping with Provider Credentials.
- Support to team members in Onboard and Off Boarding Formality.Weekly schedule a Quality call for discuss with Errors and Action plan along with RCA activity.
- Escalation email respond to client & Leadership and also Process update share to Team leads and Associates.
- Provided reporting for forecast analysis and ad-hoc reporting in support of decision-making.
Senior Processor Transaction Associate
ACCENTURE SERVICE PVT LTD
11.2012 - 11.2017
- Company Overview: US Healthcare BPO / KPO
- Working for US HealthCare Process
- - Claims Adjudication
- Understand healthcare basic concepts (member, provider, CPT, diagnosis member cost share etc.) and claim level manual entry in I/O patient claims into HCFA, UB and Member submitted Form
- Good knowledge on claim adjudication processing & Resolve pending claims (Medicare, Medicaid and Blue card claims) from work flow in ULTRA queue
- Manually claim adjustment, void and create a new claim for if process require
- Multiple pricing tool used to particular service for the provider payment
- Claims Auditing In DLA’s and SLA's
- Claims auditing by validate member benefit coverage in foundation systems and claims adjudicated validate from EPIC Tapestry application
- Expert in Analyzing CDID (Contract Design Interpretation Documents) to pay the claims as per payer contract
- Coordinates with team lead to take the ON-Shore call for process update and clarification in weekly once
- As a team internal auditor I have conduct assessment and refreshers training for team maintain 100% quality met in DLA's SLA’s and financial and process accuracy
- Processor did any error I found that error in auditing I will do RCA for future avoid that particular error and I will teach for how to avoid that error
- Preparing consolidated daily production, Quality report and circuit day to day within team members
- Handling team with the volume of 14 members
- Email communication with client for process update and all clarification sharing to team members
- US Healthcare BPO / KPO
Education
BSC - Computer Science
Nandha Arts & Science College
01.2011
HSC - undefined
State Board
01.2008
SSLC - undefined
State Board
01.2006
Skills
- Excellent communication and presentation skills
- Good team player
- Organized and well-structured at work
- Independent and self-motivated
- Committed to deadlines and schedules
- Production monitoring
Languages
English
Tamil
Personality Traits
- Enterprising
- Creative
- Energetic
- Sincere
- Optimistic
- Excellent Verbal and Written Communication Skills
- Ability to deal with people diplomatically
- Comprehensive problem solving abilities
- Willingness to learn
- Interpersonal Skill
- Team facilitator
- Self-motivated
- Creative mind
- Skill
Roles And Responsibilities
- Claims Auditing In DLA’s and SLA's
- Claims auditing by validate member benefit coverage in foundation systems and claims adjudicated validate from EPIC Tapestry application.
- Expert in Analyzing CDID (Contract Design Interpretation Documents) to pay the claims as per payer contract.
- Coordinates with team lead to take the ON-Shore call for process update and clarification in weekly once.
- As a team internal auditor I have conduct assessment and refreshers training for team maintain 100% quality met in DLA's SLA’s and financial and process accuracy.
- Processor did any error I found that error in auditing I will do RCA for future avoid that particular error and I will teach for how to avoid that error.
- Preparing consolidated daily production, Quality report and circuit day to day within team members.
- Handling team with the volume of 14 members.
- Email communication with client for process update and all clarification sharing to team members.
Academicsprofile
- BSC Computer Science, Nandha Arts & Science College, Erode, 2008-2011, 70%
- HSC, State Board, Tirupur, 2007-2008, 76%
- SSLC, State Board, Tirupur, 2005-2006, 70%
Additionalresponsibilities
- Cascading Client updates and instructions to the team Members.
- Everyday update OPEX board, 3
- 3 Metric and control chart.
- Helping the Team in terms of clarifying doubts and increasing team Quality and Productivity.
- During absence of supervisors, I will take the responsibilities to complete day to day activity.
- Allocating the workflow to the team members for maintain team target day wise.
Appreciationsandawards
- GEN_ AI Certifications completed in NTT DATA
- Training Champions & Certified Trainer in NTT Data
- NUMERO UNO AWARD – I get the Best Team player award.
- BEST TEAM AWARD - Team members Maintain Production and quality achieved.
- INNOVATION AWARD – Give more ideas for BOT Automation process that is more useful increase production and Quality.
Hobbies and Interests
- Playing Cricket
- Listening to Music
- Chatting with friends
Disclaimer
I hereby declare that the information given above is true to my extent of knowledge and belief.
Personal Information
- Father's Name: Muthiah.M
- Date of Birth: 11/25/90
- Gender: Male
- Nationality: Indian
- Marital Status: Single
Timeline
Team Lead Role
NTT DATA
05.2018 - 12.2024
Senior Processor Transaction Associate
ACCENTURE SERVICE PVT LTD
11.2012 - 11.2017
HSC - undefined
State Board
SSLC - undefined
State Board
BSC - Computer Science
Nandha Arts & Science College
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