Channappa Gouda
Process Consultant
Bengaluru
Summary
Dynamic Senior Process Consultant with expertise in business process analysis and claim adjudication at StarTek. Proven track record of optimizing workflows and achieving a 98% accuracy rate in processing medical claims. Skilled in ICD-10-CM coding and fostering strong client relationships, ensuring compliance and enhancing operational efficiency.
Overview
3
3
Languages
8
8
years of professional experience
Work History
Senior Process Consultant
StarTek
11.2024 - 06.2026
- Researched and resolved discrepancies between documentation and billing information before claim submission.
- Validated information on medical claims submitted by patients seeking reimbursement from their insurance companies.
Process Consultant
Sagility Pvt Ltd
09.2023 - 09.2024
- Analyzed process workflows to identify areas for improvement and optimize efficiency.
- Researched discrepancies between documentation and billing information to resolve issues before claim submission.
- Coded diagnoses and procedures from patient medical records using ICD-10-CM and CPT-4 codes.
- Reviewed patient medical records for accuracy, completeness, and compliance with coding regulations.
- Maintained the confidentiality of patient information in accordance with HIPAA regulations.
- Validated information on medical claims submitted by patients seeking reimbursement from their insurance companies.
- Coded and processed claim forms for payment, ensuring all required information was provided before eligible payments were made.
Process Consultant
HGS - Hinduja Global Solutions
07.2022 - 09.2023
- Recommended strategies to automate manual tasks and replace outdated technologies.
- Designed and implemented new procedures and systems to improve operational efficiency.
- Performed root cause analysis to identify underlying issues in existing processes.
- Processed 150+ medical claims per day with a 98% accuracy rate, ensuring timely reimbursement.
Customer Service RepresentativeRe
Reliance Jio Infocomm
04.2018 - 05.2022
- Responded to customer inquiries and provided accurate information about products and services.
- Developed strong customer relationships by providing personalized assistance and support.
- Provided customers with accurate information about products and services.
- Provided excellent customer service by resolving customer complaints in a timely manner.
- Delivered exceptional customer service by resolving customer inquiries and complaints, contributing to high customer satisfaction.
Education
Bachelor of Science - Computational Science
Gulbarga University
Gulbarga, India 04.2001 -
Skills
Business process analysis
Claim Adjudication
Medical Terminology
CPT Codes
HCPCS Codes
ICD-10-CM Codes
Timeline
Senior Process Consultant
StarTek
11.2024 - 06.2026
Process Consultant
Sagility Pvt Ltd
09.2023 - 09.2024
Process Consultant
HGS - Hinduja Global Solutions
07.2022 - 09.2023
Customer Service RepresentativeRe
Reliance Jio Infocomm
04.2018 - 05.2022
Bachelor of Science - Computational Science
Gulbarga University
04.2001 -