Sowmiya Namburajan
Pudukkottai
Summary
Healthcare Operations Specialist with 4+ years of experience in U.S. healthcare processes, currently working as a Senior Process Associate and performing SME responsibilities. Skilled in member management, EDI 834 processing, audit handling, and HIPAA compliance. Proven track record in leading training batches, driving process improvements, and managing revenue raw data. Recognized for automation initiatives, team mentorship, and consistent delivery in SLA-driven environments. Possesses basic knowledge of Epic Systems and Electronic Medical Record systems and an understanding of their role in managing patient information and healthcare workflows.
Overview
4
4
years of professional experience
2020
2020
years of post-secondary education
Work History
Senior Process Associate
Accenture Solutions Pvt. Ltd.
Chennai
03.2022 - Current
- Led knowledge transition and training for multiple new hire batches (2024), mentoring associates and improving productivity.
- Conducted daily client interactions for capacity planning, SLA management, and process improvement discussions.
- Validated patient/member eligibility using Mainframe systems (Citrix), ensuring compliance with HIPAA standards.
- Performed quality audits of EDI 834 files, reducing membership data errors and improving audit readiness.
- Designed and implemented process automation initiatives, reducing manual efforts and improving accuracy.
- Managed BAU reporting (production trackers, dashboards, inventory), enabling data-driven decision-making.
- Escalation & Issue Handling: Conducted RCA for process issues, coached associates, and ensured quick resolution.
- Recognized for knowledge transfer, mentorship, and leadership contributions that improved team performance.
- Awards: Consistent Performer of the Year, Good Samaritan Award (Quarter), Star of Business (3x), Encore Award (2023).
- Process Automation: Contributed to deployment of multiple automation solutions, improving accuracy and reducing manual work.
- Leadership: Guided teams through training, RCA, and process improvements, ensuring SLA adherence.
- Client Recognition: Appreciated for seamless knowledge transfer, cross-team collaboration, and performance delivery.
Education
Bachelor of Computer Applications -
JJ College of Arts & Science
PudukkottaiSkills
- Facets application
- Benefits & Coverage Validation
- EDI 834 Processing
- Query Management
- Salesforce
- MS Office
- Citrix
- Mainframe Systems
- HIPAA Guidelines
- Training
- Knowledge Transition
- Process Automation
- Escalation Handling
- Revenue Raw Data Management
- Strategic Planning
Achievements Leadership
Consistent Performer of the Year, Good Samaritan Award (Quarter), Star of Business (3x), Encore Award (2023), Contributed to deployment of multiple automation solutions, improving accuracy and reducing manual work., Guided teams through training, RCA, and process improvements, ensuring SLA adherence., Appreciated for seamless knowledge transfer, cross-team collaboration, and performance delivery.
Skills
Facets application, Benefits & Coverage Validation, EDI 834 Processing, Query Management, Salesforce, MS Office (Excel, Word, Outlook, PowerPoint), Citrix, Mainframe Systems, HIPAA Guidelines, Training, Knowledge Transition, Process Automation, Escalation Handling, Revenue Raw Data Management, Strategic Planning
Languages
Tamil
First Language
English
Upper Intermediate
B2
Timeline
Senior Process Associate
Accenture Solutions Pvt. Ltd.
03.2022 - Current
Bachelor of Computer Applications -
JJ College of Arts & Science