Diaa Jangda
Pune
Summary
Results-driven Payments Specialist with over 7 years of experience processing customer payments and resolving payment-related inquiries. Proven expertise in managing payment transactions, identifying and resolving issues in transaction documentation, and guiding customers through payment processes. Possess extensive knowledge of healthcare insurance laws, including HIPAA and PHI regulations. Skilled in data analysis, Excel, and distinguishing between fraud, abuse, and overutilization. Hands on: Compliance, Auditing Expert & Training experienced in managing end-to-end project lifecycles and ensuring strict adherence to governance laws and industry standards. Adept at leading large-scale, global projects, optimizing processes, and maintaining focus on risk management, compliance, training and quality assurance.
Overview
9
9
years of professional experience
Work History
Quality Executive Compliance (Repayments)
FPL Technology private limited (One Card)
06.2024 - Current
- Identifying, assessing, and mitigating risks in customer service processes
- Ensuring compliance with regulatory standards to minimize complaints and escalations
- Handling customer grievances efficiently to maintain satisfaction
- Developing a framework for managing nodal grievances and escalations to ensure timely resolution
- Establishing a nodal point of contact for escalated cases
- Streamlining processes for inbound complaints to reduce response times
- Training teams to manage diverse customer concerns with empathy and efficiency
- Implementing tools or systems for tracking and resolving cases effectively
- Conducting skill-enhancement programs for teams to improve communication and problem-solving abilities
- Keeping staff updated on changes in policies, regulations, and customer service best practices
- Regularly auditing customer interactions for compliance and quality standards
- Using feedback to improve both agent performance and overall customer satisfaction
Program Manager
AIQOD
04.2024 - 06.2024
- Developed and implemented Standard Operating Procedures (SOPs) for [specific processes or areas], ensuring adherence to industry regulations and standards
- Created and delivered presentations to stakeholders, effectively outlining project goals, milestones, and key deliverables, resulting in improved engagement and buy-in
- Established project tracking systems, monitored progress, identified risks, and implemented corrective actions to ensure timely and high-quality project delivery
- Led compliance audits to assess adherence to regulatory requirements and internal policies, identifying areas for improvement and driving corrective actions
- Collaborated with cross-functional teams to align project activities with strategic objectives, optimizing resource allocation for efficient and timely delivery
- Maintained thorough documentation of project activities, including meeting minutes, action items, and audit findings, ensuring accuracy and compliance with internal standards
Quality Assurance & Internal Audit Compliance
Credence resource management
08.2023 - 03.2024
- Handling consumer collection complaints related to Dispute, Fraud, Bankruptcy, and third-party complaints for Healthcare, AT&T, Comcast, T-Mobile, and Cox Communication is a crucial aspect of our operations
- After receiving complaints locate and restrict the account of the consumer
- We also diligently work on various legal aspects such as Litigations Presuit, Lawsuit, Subpoena, Arbitration, and Class Lawsuits to ensure a fair resolution
- In addition, we address complaints filed with CFPB BBB by locating the respective accounts and implementing necessary restrictions
- We collaborate with credit reporting bureaus like Transunion, Equifax, and Experian to gather relevant information for resolving the complaints
- We conduct risk analysis on the complaints and take necessary measures to avoid future mistakes and improve our processes
- To identify potential risks, we maintain monthly penalty logs and generate reports for thorough evaluation
- We also monitor calls and create call synopses for the dockets, ensuring compliance with our standards
Senior Specialist Payment Accuracy
Cotiviti India PVT LTD
02.2018 - 08.2023
- As a successful Payment Accuracy Specialist, I was identifying, implementing new concepts that will recognize incorrect payments
- Calculating Claims and checking for the payment was paid correctly or no if not then use to build those claims on decipher after the payment calculation
- The compliance laws were followed by us was HIPAA (Health Insurance Portability & Accountability Act), PHI (Protected Health Information), FTC (Federal Trade Commission)
- Internal Compliance Audit to check if anyone is not violating the Healthcare laws
- Worked as a contract compliance support for Humana
- Job role included extraction and collecting data from multiple sources of contracts and made amendments to calculate the overpayments for onshore team
- Followed up with insured individual regarding premium and deductibles payment
- Collaborated with claims department to resolve fraudulent claims issue
- Evaluated all evidences with goal of creating positive outcomes for clients claims and generating revenue
- Educated new hires on job responsibilities with side-by-side training
- Exceeded productivity expectations while ensuring to meeting quality standards
- Created SOP’s and knowledge nuggets for the team for the updates
Executive- Contact Center
Fareportal India PVT LTD
05.2016 - 07.2017
- Worked for Inbound Sales Process
- Generated Extra Sales revenue for booking Domestic & International Flights for USA
- Did cross sales for flight bookings (e.g
- Insurance & Seat booking)
- Also use to help to change flight details
Education
Post Gradutation in Project Management -
mit distance learning
10.2023
Six Sigma Black Belt -
XLNC
11.2021
Bachelor of Arts -
Savitribai Phule Pune University
10.2015
Skills
- Excellent communication skills
- Customer service-oriented
- Compliance
- Flexible
- Social media knowledge
- Administrative support specialist
- Risk Analyze
- Project planning
Accomplishments
- Handled Medicare Project for 6 Months.
Additional Information
Basics of Business Analytics Certification, Advanced Excel, DRA Certified
Emailaddresses
- Kiran.gend@gmail.com
- Diaa.jangda@gmail.com
Timeline
Quality Executive Compliance (Repayments)
FPL Technology private limited (One Card)
06.2024 - Current
Program Manager
AIQOD
04.2024 - 06.2024
Quality Assurance & Internal Audit Compliance
Credence resource management
08.2023 - 03.2024
Senior Specialist Payment Accuracy
Cotiviti India PVT LTD
02.2018 - 08.2023
Executive- Contact Center
Fareportal India PVT LTD
05.2016 - 07.2017
Post Gradutation in Project Management -
mit distance learning
Six Sigma Black Belt -
XLNC
Bachelor of Arts -
Savitribai Phule Pune University
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