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
Skilled in Microsoft Office tools
Friendly, positive attitude
Teamwork and collaboration
Dependable and responsible
Organization and time management
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.