Summary
Work Profile
Overview
Work History
Education
Skills
Interests
COMPUTER LITERACY
Timeline
DECLARATION
Generic
JAYAPRAKASH GANESAN

JAYAPRAKASH GANESAN

Senior Process Executive
Coimbatore

Summary

Detail-oriented and dependable professional with a proven track record of effectively managing multiple priorities while maintaining a positive attitude. Strong willingness to embrace additional responsibilities to achieve team objectives and drive success. Known for fostering collaborative environments and enhancing team performance through proactive problem-solving and adaptability. Committed to continuous improvement and delivering high-quality results in fast-paced settings.

Work Profile

Cognizant technology solution (CTS) – Coimbatore


  • Position : Senior Process Executive ( SPE )
  • Project : HCSC -PWI – Provider written inquiry
  • Experience Skills : PAYER – Adjudication (US Healthcare )
  • Working Software : CITRIX
  • Experience : Oct 2021 to Oct 2025

Overview

4
4
years of professional experience
2
2
Languages

Work History

Senior Process Executive

Cognizant
09.2021 - 10.2025
  • Over 4 years of experience in Healthcare Insurance
  • Health care Domain currently involved in Payer side, Automation Adjudication process, Manual Adjudication, Manual Pricing Claims, Adjustment process ,Claims keying into system .
  • Responsible for all individual complete risk assessment in detecting the potential fraudsters
  • Adjudication Process undertaken for the applicants seeking insurance with the client organization.
  • Keeping track of the customers’ accounts periodically, blocking the accounts which are found to be fraud & taking further actions as per the guidance of the client.
  • Taking a risk-based approach ensures that we can determine on a client-by-client basis.
  • Verifying the personal documents such as Insurer’s Name, DOB, Insurance details etc.
  • Verifying the details of Provider details such as Name, National Provider ID, Address etc.
  • Monitoring the Claims Properly to avoid Under payment as well as Over payment
  • Approving the Claims after Validating the enough genuine indicators
  • Executed healthcare claim processing and administration software utilization while ensuring complete accuracy in inquiry handling
  • Achieved 100% accuracy while addressing member inquiries for more than six months. Integrated skills across Cognizant Digital Operations and Digital Systems and Technology practices.
  • I'm responsible for delivering business solutions that support the healthcare claim function, leveraging a knowledge of the processes and systems to receive, edit, price, adjudicate, and process payments for claims.
  • Transitioned to SME role within three years, providing support for technical inquiries. Assisted team members in resolving doubts and enhancing problem-solving skills. Facilitated knowledge sharing through clear explanations and effective guidance.
  • Self-motivated, with a strong sense of personal responsibility.

Education

HSC -

Sri Lathangi Vidhya Mandir School
03.2018

B.com - Information technology

SRI KRISHNA ARTS AND SCIENCE COLLEGE
04.2021

SSLC - undefined

Sri Lathangi Vidhya Mandir School
03.2016

Skills

Claims and Adjusting: Claims

Interests

Travel, Sports, Photography

COMPUTER LITERACY

  • Operating system: WINDOWS 7, WINDOWS XP, WINDOWS 10
  • Programming languages: TALLY ERP 9, HTML, VISUAL BASIC
  • Application: MS OFFICE [WORD, EXCEL, POWERPOINT]

Timeline

Senior Process Executive

Cognizant
09.2021 - 10.2025

B.com - Information technology

SRI KRISHNA ARTS AND SCIENCE COLLEGE

SSLC - undefined

Sri Lathangi Vidhya Mandir School

HSC -

Sri Lathangi Vidhya Mandir School

DECLARATION

All the details mentioned above are true and correct to the best of my knowledge and beliefs.

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JAYAPRAKASH GANESANSenior Process Executive