Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic
BANUMATHY SHANMUGAM

BANUMATHY SHANMUGAM

Summary

20 years of experienced Healthcare professional prepared for leadership in high-stakes environments. Accomplished executive with comprehensive experience leveraging leadership skills to develop and expand multiple businesses. Instrumental in managing client accounts. Proven track record in driving operational efficiency, strategic planning, and risk management. Strong focus on team collaboration and achieving results with adaptability to changing needs. Skilled in project management, and stakeholder communication. Reliable and flexible, with commitment to excellence and integrity.

Overview

21
21
years of professional experience
1
1
Certification

Work History

Senior Assistant Vice President

EXL Service
06.2016 - Current
  • Leading the Payment Integrity coding and clinical payer audit, Risk adjustment, and RCM operations for following specialties: IPDRG, Surgery coding for all major surgeries for both Facility and Professional claims, EM and ED professional claims, Risk Adjustment and Urology provider coding/denial management.
  • Managing 3 large payers, 3 mid-size payers, saving $1 billion across all the payers.
  • Implementing robust strategies to drive PNL of the process.
  • Currently Managing 45+ projects and 700 team members.
  • Maintains and Implements policies and procedures; evaluates and improves the effectiveness of policies, procedures and workflow.
  • Interacted well with customers to build connections and nurture relationships. Leads MBR and QBR calls.
  • Assisted in recruiting, hiring and training of team members.
  • Trained and guided team members to maintain high productivity and performance metrics.
  • Handled problematic customers and clients to assist lower-level employees and maintain excellent customer service.

Assistant Manager

Saicle1 Solutions Private Limited
05.2015 - 06.2016
  • Responsible for service delivery of following specialties: Surgery - Integumentary, Gastrointestinal, Endoscopic procedures, pathology, ED, EM, SNF and PT/OT.
  • Supervised day-to-day operations to meet performance, quality and service expectations.
  • Participate in and contribute to client conference call, department meeting and management meeting.
  • Developed strong working relationships with staff, fostering a positive work environment.
  • Opened and closed location and monitored shift changes to uphold successful operations strategies and maximize business success.

Senior Team Lead

Serco Global Services
04.2010 - 04.2015
  • Responsible for service delivery of Emergency Department coding.
  • Managed 40 members team.
  • Monitor Daily work process and meets SLA.
  • Maintained accurate records of the projects, providing regular updates to senior management on progress and potential roadblocks.
  • Educated staff on organizational mission and goals to help employees achieve success.
  • Oversaw the implementation of new systems or processes within the team successfully navigating change management challenges.

Team Leader

Allzone Management Solutions Ltd
09.2009 - 03.2010
  • Responsible for coding and auditing of Gastrointestinal surgery, Anesthesia, Pain management, ED, EM and Ancillary services.
  • Performed coding and auditing of pilot claims, responsible for new process transition.
  • Managed 15 members team, 5 projects.
  • Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
  • Empowered team members by delegating responsibilities according to individual strengths and areas of expertise.
  • Managed conflict resolution among team members, fostering a positive and collaborative work environment.
  • Developed team members'' skills through targeted coaching sessions, resulting in improved individual performance.

Group Coordinator

Ajuba Solutions Private Limited
12.2004 - 08.2009


  • Perform Quality audits for Anesthesia and Pain management records using CPT, HCPCS and ICD-9-CM coding guidelines.
  • Processed 250 Claims daily with 98% Accuracy and Achieving Productivity Goals.
  • Developed comprehensive schedules for events, ensuring timely completion of tasks and successful event execution. Managed 10 member team
  • Identified potential risks or obstacles within group projects, proactively addressing them in order to minimize negative impact on outcomes.
  • Month End Reports, Week End Report, Day report to Proficient in preparing Day pertaining to coding audit process.


Trainee Coding Executive

NetVision Cybertech Ltd
12.2003 - 11.2004
  • Learned Medical Coding, Medical billing and complete revenue cycle management, processes, and programs quickly.
  • Attended CPC training courses to build understanding of CPT, HCPCS, ICD-9-CM, processes, techniques, and industry.
  • Participated in on-the-job training, working closely with supervisors and coworkers and asking appropriate questions.
  • Supported departmental tasks to increase understanding of industry processes.

Education

CPC, CPMA -

Americal Academy of Professional Certification
USA
09-2004

Bachelor of Science - Zoology

Queen Marys College
Chennai, India
06-2001

Skills

  • Operations management
  • Organizational development
  • Proficient in following specialties: ED, EM, Surgeries, - Major and Minor procedures for all the specialty, Endoscopic Procedures, Pathology, Ancillary services, Anesthesia, Pain Management, Risk Adjustment and Value based care
  • Managerial experience on DRG, Radiation Oncology, and Clinical review of Hospital bill review and Implant Audit

Certification

Certified as the "Leading Organizations and Change Program" from the MIT Sloan School of Management.

Timeline

Senior Assistant Vice President

EXL Service
06.2016 - Current

Assistant Manager

Saicle1 Solutions Private Limited
05.2015 - 06.2016

Senior Team Lead

Serco Global Services
04.2010 - 04.2015

Team Leader

Allzone Management Solutions Ltd
09.2009 - 03.2010

Group Coordinator

Ajuba Solutions Private Limited
12.2004 - 08.2009

Trainee Coding Executive

NetVision Cybertech Ltd
12.2003 - 11.2004

CPC, CPMA -

Americal Academy of Professional Certification

Bachelor of Science - Zoology

Queen Marys College

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