ASVITHA K
Chennai
Summary
Seasoned Manager of Operations with a proven track record at STAR HEALTH AND ALLIED INSURANCE, adept in staff training and operations oversight. Excelled in process improvements and team leadership, significantly enhancing productivity. Skilled in data management and performance optimization, demonstrating a keen ability to exceed targets through innovative strategies and a focus on staff development.
Overview
14
14
years of professional experience
32
32
Certification
Work History
Manager - Claims Processing and Grievances
STAR HEALTH AND ALLIED INSURANCE
Chennai
11.2022 - 02.2024
- Followed up with customers on unresolved issues.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Developed in-depth understanding of insurance policies and procedures.
- Collaborated with internal departments and external vendors to resolve claims.
- Modified, updated and processed existing policies.
- Determined appropriateness of payers to protect organization and minimize risk.
- Calculated adjustments, premiums and refunds.
- Maintained confidentiality of patient finances, records, and health statuses.
- Processed and finalized appeals and grievances within agreed-upon turnaround time.
- Reduced bottlenecks by implementing standardized equipment maintenance schedule and processes
- Submitted verbal and written notification to members and providers.
- Spearheaded negotiation of union contracts as company representative.
- Demonstrated structured thinking to solve problems and conduct root cause analysis.
- Reduced grievances and arbitration needs by educating frontline managers on techniques for enhancing interactions between labor and leadership.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Applied effective time management techniques to meet tight deadlines.
- Communicating with hospitals and fixing issues related to insurance.
- Audit parameters definition to reduce errors.
Associate Manager
SUTHERLAND GLOBAL SERVICES
Chennai
06.2021 - 11.2021
- Supervised hourly and temporary personnel, provided work direction and reviewed work processes
- Boosted company productivity and morale through consistent engagement with team members and management
- Answered questions and recommended solutions to address escalated customer complaints
- Took initiative in handling problems and used independent judgment to take immediate corrective actions
- Look towards the qualitative approach of the team members by auditing their contacts where the customers are dissatisfied and try to improve by providing the proper resolution
- Preparation of the reports for the daily manager call as well as weekly performance call to meet the client expectations
- Rewards and Recognitions program will be conducted based on the weekly, monthly as well as quarterly stack ranking report
Manager- Subrogation
EXL SERVICES
Chennai
11.2015 - 06.2021
- Joined as a subrogation analyst and worked for a US health care process (Humana Insurance)
- Will be working on the agreements and will connect with the clients, legal advisors/attorneys, other insurance carrier reason for the incident in order to subrogate the money
- In case of litigation, and they need us to intervene for our case file will talk to our in-house attorney
- Then started handling Medicare plan (single handed), a government plan where we need to be quite confident on the pro-rata percentage
- Worked on recoupment process by checking on the provider payments
- Started handling a team of 10 people in escalations
- Training will be offered then and there if there is any change in the process
Customer Service Representative
SUTHERLAND GLOBAL SERVICES
Chennai
07.2010 - 07.2013
- Answered inbound calls to greet and assist customers with various needs and questions
- Resolved customer inquiries, complaints, and issues providing insightful solutions
- Researched assistance requested and offered accurate information to resolve issues and respond to inquiries
- Addressed customer concerns and complaints and resolved issues promptly
- Followed predefined procedures to evaluate, solve, and escalate product-related issues
- Escalated advanced customer issues to next-level support or managers to facilitate resolution
- Evaluated functionality and performance of software and hardware recommending improvements and solutions
Education
Business Administration -
Manipal University
Rajasthan03.2006
S.S.L.C. - Bio- Maths
SRV Girls Higher Secondary School
Rasipuram03.2004
High School Diploma -
Mahatma Gandhi Centenary Vidyalaya
Trichy03.2004
Skills
- Claims Servicing
- Grievance Redressal
- Communication with hospitals
- Employee or Staff management
- Operations
- FMEA Auditing
- Budget Control
Certification
From AIGPE Institution completed the below courses:
- Six Sigma- Certified White, Yellow, Green and Black Belt. (Gold Credential)
- In Lean Management- Certified as Lean Specialist, Lean Expert, Value Stream Mapping Specialist and Just in Time Specialist. (Diamond Credential)
- In Minitab: Certified as minitab beginner (Graphical tools), Minitab Proficient and Minitab Expert.(Platinum Credential)
- In Project Management: Certified as a Brainstorming Specialist, Project Charter Specialist and Project Schedule Specialist (Monitor and Control) - (Titanium Credential)
- Quality Champion: Certified as a Quality Champion by Completing all four credentials (Gold, Diamond, Platinum and Titanium) followed by the certifications on Voice of customer techniques, Pareto analysis, Kano analysis, Quality Functional Deployment, Seven basic tools of quality expert, FMEA Specialist, Five Forces Analysis Specialist, Process mapping and flow chart specialist.
From Coursera completed Asana- Project Network.
From Six Sigma Amsterdam Academy, completed the below mentioned certifications:
- Supply Chain Management Expert
- Six Sigma Black Belt
- Process Improvement and Process Mapping certification
- Certified Risk Management FMEA ISO 31000 Expert
From SEBI/ NISM, completed SEBI Investor Exam with 92%.
From Udemy completed the below mentioned courses:
- Ultimate Microsoft Excel Course- Beginner to Expert Level
- Executive Diploma in General Management
- Executive Diploma in Business Administration
- Executive Diploma in Operations Management
From United Latino Students Association, completed certification on " Build Your Own Chat Bot".
From HP Life Completed the below courses:
- Business Email - HPL-EN11
- Business Communications
- Course on Presenting data
- Effective Presentations
- Effective Leadership Course
- Cybersecurity Awareness Course
- Customer Experience For Business Success
From Cisco Networking Academy, completed Introduction to Data Science Course.
Currently undergoing Business Communication 8 weeks course, through Swayam offered by Jain University and IIM Bangalore.
Attached List of Courses with their certifications.
Languages
Tamil
First Language
References
References available upon request.
Timeline
Manager - Claims Processing and Grievances
STAR HEALTH AND ALLIED INSURANCE
11.2022 - 02.2024
Associate Manager
SUTHERLAND GLOBAL SERVICES
06.2021 - 11.2021
Manager- Subrogation
EXL SERVICES
11.2015 - 06.2021
Customer Service Representative
SUTHERLAND GLOBAL SERVICES
07.2010 - 07.2013
Business Administration -
Manipal University
S.S.L.C. - Bio- Maths
SRV Girls Higher Secondary School
High School Diploma -
Mahatma Gandhi Centenary Vidyalaya
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