Jeyashri Ganesan

• Resource Allocation : Ensure that necessary resources are available to run the business
• Monitoring Performance : Establish key performance indicators (KPIs) and continuously monitor process performance against the defined metrics
• Collaboration : Work closely with cross functional teams to ensure process alignment with organizational goals
• Risk Management and Compliance :

Identifying Risks : Assess potential risks associated with Process and develop mitigation strategies

Ensuring Compliance : Ensure that processes compliant with relevant regulations, standards and internal Policies

Audit and Review : Conduct regular audits and reviews to ensure compliance and identify further improvement areas.

• Handling team of 42 members working on various streams like Adjudication, Correspondence and UM Intake.
• Handling five different states under BCBS.
• Transitioned the process and went live successfully.
• Cascading the updates to the team on time and monitor the performance to make sure the SLA's are met without any deviations.
• Acknowledging the accomplishments by team members for exceptional performance
• Encourage team to discuss and gather ideas for continuous process improvements
• Connecting with the team members to understand their process challenges and provide feedback on time.
• Drove operational efficiency through data-driven decision-making processes, leveraging analytics tools for informed strategy development.
• Leveraged data and analytics to make informed decisions and drive business improvements.

• Provide L1 support on RPA process monitoring
• Perform daily health checks and do real-time monitoring of automation/bots for smooth business delivery
• Ensure that the bot processes are being triggered as scheduled
• Coordinate with the DEV Team and Business team for further enhancements/during upgrade testing
• Analyze the Reasons for BOT Struck, Document it and take actions accordingly
• Report the BOT performance data to key stakeholders on a weekly basis
• Monitor ticketing tools for any issues raised by Business team and make sure to resolve within defined timeline
• Respond to the issues on timely manner as agreed to the customer
• Analysts the BOT performance reports and check for opportunities to enhance the performance (increasing BOT Completion%).

• Create an environment oriented to trust, open communication, creative thinking, and cohesive team effort
• Provide the team with a vision of the project objectives
• Motivate and inspire team members
• Coach and help develop team members
• Ensure discussions and decisions lead toward closure
• Encourage creativity, risk-taking, and constant improvement
• Recognize and celebrate team and team member accomplishments and exceptional performance
• Familiarize the team with the customer needs, specifications, design targets, the development process, design standards, techniques and tools to support task performance
• Assure that the team addresses all relevant issues within the specifications and various standards
• Ensure deliverables are prepared to satisfy the project requirements, cost and schedule
• Provide status reporting of team activities against the program plan or schedule
• Transition of processes from Onshore team to Offshore team
• Leads a Customer driven project which results in Financial Dollar Savings to the Client.

• Carry out process level quality audits through focused sampling for assessing and improving program quality
• Analyze and document the Internal and External errors and identify the root cause and update the same in the CC log
• Identify actions items for the process improvement and implement the same through CQIP
• Program performance reporting, CQIP action log tracking
• Own and drive CA and PA initiative across the team
• Maintain the agreed level of quality in the client operation
• Training all the QC associates in the client program
• Responsible for providing inputs to the Trainers based on multiple levels of analysis for enhancing program quality
• Preparing monthly CU and PI report for the designated accounts
• Tracking the performance of the new joiners and raising alert if any deviation is found.

• Training the New associates who are joining to the team as per schedule with the medical billing & client specific knowledge.

• Quality checking of the claims processed by the trainees and examiners.

• Ability to adjudicate CMS1500, UB92/UB04 types of claim forms
• Ability to easily adapt to work place changes
• Ability to perform mathematical calculations and analytical duties for specialty services
• Ability to organize and prioritize workload
• Responsible for the accurate and timely completion of tasks assigned and adhering to hourly/daily production standard in accordance with established Policies and Procedures
• Process claims with an accuracy rate not to fall below 98%
• Research all problem claims and make payment decisions in a timely manner
• Identify issues that may influence compliance standards and notify Supervisor or Lead immediately
• Communicates with management and makes recommendations to improve processes.