Divya M

*Acting as the primary point of contact for the branch, providing comprehensive support

*Supporting a team of 4-5 Client Managers at the Branch

*Responsible for end-to-end support of the policy lifecycle services

*Coordinating with internal operating team to get the renewal activities completed on time

*Handling queries effectively, aiming to minimize re-work at service center

*Understanding Client Manager requirements when completing the renewal activities documentation inclusive of Census, SBC , Proposals etc.

*Independently & effectively managing multiple tasks at once

Senior Process Executive- 2013-2015

• Processed Medical, Institutional and Dental Claims in Facets application based on the edits and following the Workflow guidelines
• Experienced in handling Home claims and Member submitted Claims
• Provided refresher trainings for new associates during Ramp-ups
• Handled LOB's - Commercial, Medigap, Medicare and Administrative services only Claims

Subject Matter Expert / Auditor- 2015-2020

• Audited Internal and External claims on daily basis and updated Quality report to the Client
• As an auditor I was responsible for providing feedback and required coaching to the team
• RCA on findings and CAPA was given on time to ensure the team meets expected SLA

Team Leader - 2020-2023

• Handled a team on 24 associates and ensured all the key metrics of performances as per the Client SLA are met and exceeded
• Daily huddles and One-on-One session to make sure each individual understands their roles and performance expectations
• Established precise targets and key performance indicators for the team
• Managed the Attendance and so could control Shrinkage
• Distributing the work to the team based on daily inventory
• Developed strategic plans and action steps to achieve team targets and deadlines.
• Provided Performance review feedback on regular basis as Weekly and Monthly
• Setting up the KRA's based on the role
• Additional training and support provided to the bottom performers
• Weekly connect with the Client to discuss on Teams performance (Production & Quality) and to understand future expectations
• Weekly Presentation with the Team to forecast each individual as well as Teams performances based on which action plans taken
• Provided immense support and mentorship to the team members
• Assign SME's to take up responsibility on weekly knowledge tests and provide feedback
• Experienced in handling attrition

• Processed US Healthcare claims- Medical/ Hospital/Dental in Citrix application
• Followed the Workflow and identified time reduction for processing claims
• Involved in Idea Generation team to implement Cost cutting