Jason Prakash S
Quality Analyst
Chennai
Summary
Ambitious Quality Analyst with track record of dependability and leadership. Knowledgeable in QA methodology with proven history of reducing errors to increase quality. Proficient in preparing test cases, plans and scripts. Dedicated to analyzing and resolving defects.
Also a Knowledgeable claims associate equipped to handle demands of denial work. Proficient in processing insurance paperwork and computing values such as co-pay's and co-insurance's. Well-versed in policy decisions and claims management
Analytical claims associate focused on balancing customer and company needs with effective use of established policies and risk standards. Skilled in efficiently completing and processing insurance forms
Overview
7
7
years of professional experience
Work History
Quality Analyst
Omega Healthcare
11.2023 - Current
- Conducted thorough root cause analyses on recurring defects, resulting in implementation of effective corrective actions.
- Provided detailed reports on quality metrics to senior management, enabling informed decision-making regarding process improvements.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Collaborated with cross-functional teams to develop and implement targeted solutions for identified quality issues, ensuring continuous improvement.
Quality Analyst
Adroit Global Solutions
01.2022 - 03.2023
- Collaborated with management to provide training on improved processes and assisted with creation and maintenance of quality training.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Developed training materials, SOPs and work instructions to supplement new team member onboarding.
- Analyzed quality and performance data to support operational decision-making.
- Created and revised procedures, checklists and job aids to reduce errors.
- Compiled and distributed weekly feedback to team leaders and managers to improve service time and quality while increasing productivity.
- Worked on US Healthcare claims and Denials
Senior Claims Associate
Access Healthcare
11.2020 - 11.2021
- Examined reports, accounts and evidence to determine integrity and accuracy of information.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Generated, posted and attached information to claim files.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Coordinated with contracting department to resolve payer issues.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Verified client information by analyzing existing evidence on file.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Calculated adjustments, premiums, and refunds.
- Reviewed 200 patient cases per week and verified insurance coverage information
- Worked on claim denials with the payer representative to resolve the claim
Claims Associate
Adroit Global Solutions
11.2018 - 11.2020
- Implemented improvements in manual and electronic billing procedures.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Examined claims forms and other records to determine insurance coverage.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Calculated adjustments, premiums, and refunds.
- Verified client information by analyzing existing evidence on file.
- Processed and recorded new policies and claims.
- Modified, updated and processed existing policies.
- Generated, posted and attached information to claim files.
- Worked on claim denials towards resolution
Customer Relationship Officer
Hinduja Global Solutions
07.2017 - 07.2018
- Used consultative techniques to understand customer needs and make strategic referrals to business partners.
- Managed customer relations on ongoing basis to maximize customer retention.
- Made customers aware of current and new programs and services.
- Managed department call volume of 120 calls per day and coordinated department schedules to maximize coverage during peak hours.
- Liaised between customers and organization with particular focus on working with sales department.
- Built long-term, loyal customer relations by providing top-notch service and detailed order, account and service information.
- Leveraged sales expertise to promote products and capitalized on upsell opportunities.
Education
Bachelor of Arts - Computer Application
Jaya College of Arts And Science
Chennai, India 06.2014 - 2017.04
Skills
Policy understanding
Accomplishments
Achieved Top Quality Award for 2 consecutive quarters
Achieved Top Performer Award for the Year
Achieved Highest Production Award for the quarter
Achieved Star Debut Award
Maintained High Quality and Production per SLA
Timeline
Quality Analyst
Omega Healthcare
11.2023 - Current
Quality Analyst
Adroit Global Solutions
01.2022 - 03.2023
Senior Claims Associate
Access Healthcare
11.2020 - 11.2021
Claims Associate
Adroit Global Solutions
11.2018 - 11.2020
Customer Relationship Officer
Hinduja Global Solutions
07.2017 - 07.2018
Bachelor of Arts - Computer Application
Jaya College of Arts And Science
06.2014 - 2017.04
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