Jayaram Ramamurthi
Chennai
Summary
Strategic Team Lead with 7+ years in US healthcare claims adjudication, specializing in commercial, Medicare, and Medicaid claims. Expertise in team leadership, process training, and quality management. Achieved consistently high-quality scores and enhanced operational efficiency through process improvements and RPA implementation.
Overview
8
8
years of professional experience
Work History
Team Leader
Sagility India Limited
Chennai
05.2022 - Current
- Leading team of claim adjudicators to deliver high-quality output meeting SLA and TAT.
- Achieved 100% quality compliance across multiple claim types consistently.
- Optimized resource allocation and planned daily workloads to enhance productivity.
- Conducted performance reviews, coaching sessions, and team meetings to drive continuous improvement.
- Served as point of escalation for complex and compliance-sensitive claims.
- Collaborated with quality training and operations teams to align with business objectives.
- Identified process risks and implemented corrective and preventive actions to enhance compliance.
Process Trainer
Hinduja Global Solutions
04.2020 - 05.2022
- Delivered end-to-end training for 3 batches (60+ new hires), including pilot batch in Coimbatore, enhancing onboarding experience.
- Conducted comprehensive training on claim validation, adjudication, payment, and FR, ensuring trainees' preparedness for real-world scenarios.
- Developed SOPs, job aids, and assessment modules.
- Ensured full adherence to HIPAA and payer-specific compliance standards.
- Evaluated trainees through mock adjudications and quality audits.
- Provided post-training nesting support, resulting in increased First Pass Accuracy among new hires.
- Recognized as Best Trainer for quality and batch performance outcomes.
Process Consultant
Hinduja Global Solutions
07.2018 - 04.2020
- Achieved 100% quality scores consistently in Commercial and Medicaid claims.
- Reduced denial rates by implementing process improvements and facilitating knowledge-sharing initiatives among teams.
- Served as escalation contact for complex adjudication and compliance issues, providing expert guidance to resolve challenges.
- Managed high-risk and High Dollar (HD) claims portfolios, ensuring zero compliance deviations to uphold regulatory standards.
Education
Bachelor of Arts - B.COM General
Jaya College of Arts And Science
Thiruninravur07-2018
Skills
Claims adjudication
- Healthcare Claims Adjudication & Compliance
- Commercial, Medicare & Medicaid Claims
- High Dollar (HD) Claims Handling
- Reimbursement Methodologies
- HIPAA Compliance
- Team Supervision & People Management
Leadership & Operations
- KPI management
- Risk Identification & Resolution
- Quality improvement
- Curriculum development
- Process Training & Curriculum Development
- US Healthcare Claims Adjudication (E2E)
- SOP & Job Aid Creation
- New Hire, Pilot & Refresher Training
- HIPAA & Compliance Training
- Trainee Evaluation & Quality Audits
- Nesting & Transition Support
- FPA & Quality Improvement
Accomplishments
Collaborated with RPA teams to implement bot-driven claim processing, reducing manual effort.
Timeline
Team Leader
Sagility India Limited
05.2022 - Current
Process Trainer
Hinduja Global Solutions
04.2020 - 05.2022
Process Consultant
Hinduja Global Solutions
07.2018 - 04.2020
Bachelor of Arts - B.COM General
Jaya College of Arts And Science