JOSEPH STEPHEN
Senior Manager
Chennai
Summary
More than fifteen years of professional experience in Operations management, Leadership, Training, Recruitment, Coaching / Mentoring, Quality Assurance and Vendor Management. Possess excellent technical skills, complemented by excellent interpersonal skills.
Overview
16
16
years of professional experience
Work History
Senior Manager
AnnexMed Pvt Ltd
03.2020 - 08.2020
- Oversaw 2 Major Projects (HBS & Adfinitas Health), managed 110 FTEs within 2 projects
- Ensured that all projects and deliverables were completed on time, and exceeded all client expectations
- Acted as senior liaison between AnnexMed and the client, always ensuring that all contract requirements were met with complete satisfaction
- Create solutions for identified process improvement areas and work with management team to implement
- Monitored and analyzed team performance, developed and implemented employee training programs
- Oversee and manage performance goals in order to make necessary process adjustments and ensure that policies, procedures and standards are followed
- Leading Team Meetings as well as one-on-one sessions to discuss performance, areas of opportunity and resolution actions/developing plans and assisting in managing the Quality Process.
Payer Configuration Associate
athenahealth Technology Pvt Ltd
03.2016 - 02.2020
- Hands on experience on Insurance Infrastructure settings and overall insurance ramifications from a global perspective, claim submission process, electronic/paper form billed to payers, and any payer-specific policies and rules governing the claim cycle
- Ability to independently create and update Athena’s Insurance database and assist in scoping of rules that minimize the risk of cash flow interruption for our clients
- Ability to prioritize, process, and resolve complex payer and client issues surrounding insurance and its rules interactions to optimize client performance
- Effectiveness in handling CRM Cases and escalation management
- Successfully engaged in multiple initiatives, including projects (Tier 9) and operational responsibilities simultaneously
- Proactively research, identify, and critically evaluate payer changes gathered from multiple sources (i.e
- Payer websites or bulletins, government announcements, CRM cases, other internal teams, and clients), summarize content, deconstruct high-level information into a detailed summary, abstract up from low-level information to a general understanding, and complete user requests as needed for the success of our clients and athena
- Troubleshoot claim rejection issues relating to Insurance policies and returned mail items, identifying and reporting on workflow trends, and ability to provide solutions to root causes
- Demonstrated a strong phone presence by initiating significant outbound calls to Payers and insurance companies, clients, healthcare specialists, or other entities, for the purpose of obtaining the required claim billing information
- Ensured accurate and timely processing of operational tasks for clients, in accordance with athenahealth’s established service metrics
- Converting payer portals from non-implementation to pre-implementation using software
- Additional Roles & Responsibilities – athenahealth Event Management (AHI SPARCS): .......With a team on 12 members including 3 Senior Leadership, managed overall company Events internally and externally
- Prepared event calendar for the internal and external events, and rolled out emails to identify opportunities for employee participation
- Managed budget and handled reporting of costs for each program/event
- Negotiate with external vendors for cost effective arrangements for large/small events
- Proven experience in organizing successful events during the course of my tenure with athenahealth
- Strong communication, team work and negotiation skills.
Sr. Process Associate
AGS Health Private Limited
08.2011 - 02.2016
- Hands on experience in Anesthesia Billing and Claims follow up
- Prepare client reports & keep them updated with AR movement
- Resolving issues found in AR edits (Ambulatory Claims Manager - EDI)
- Assigning AR accounts to the team & make sure that the work is getting completed within the TAT
- Balancing and planning work as to ensure smooth processing
- Handling additional queries and issues within the team
- Handling Client related escalations
- Work for other clients in case of emergency situations
- Training newcomers on the process & help them deliver the required results expected
- Quality check on the accounts based on the parameters assigned by the clients
- Resolve physician queries regards to billing.
Senior Account Executive
Ajuba Solutions (India) Pvt
04.2005 - 07.2011
- Analyze the US Health care Claims/Billing information to ascertain the reason for the denial of payment
- Resolving the issues raised in the Claims/Patient account by Interacting with the Federal Government or other Private health Insurance companies (Anesthesia Billing)
- Keeping an overview as to the movement of AR
- Balancing and planning work as to ensure smooth processing
- Handling additional queries and issues within the team
- I am responsible for all the escalated cases within the team and to solve 95% at my end
- Expediting issues to designated account manager on behalf of the team
- Working on additional reports as and when the need arises
- Primary analysis of AR received so as to eliminate zero balance accounts
- Identifying trends and suggesting alternative course of action after in-depth analysis
- Worked on various insurance carriers and developed extensive knowledge
- Working on denials and creating appeals to ensure payment on accounts
- Consolidating reports pertaining to additional records requested by the entire team and taking action when received
- To ensure that work is done within the turnaround timing that is fixed
- To always take care of the comfort level of my team and to be supportive, motivating and to channel their potential in the right direction
- Proton web BPO
CSR/Team Mentor
Proton Web BPO
Chennai
11.2004 - 03.2005
- Involved in analysis and Campaign in different types of Mortgages
- Extract information from users based on the required parameters and convert it into potential lead generating revenue
- Lead a team of 5 members & Co-ordinating with them in achieving the team targets
- Managing & Updating reports regarding weekly sales status
- Preparing monthly target schedules for team members to give result-oriented sales
Education
Bachelor of Commerce -
University of Madras
Skills
Project Management
Hobbies
I am a philatelist collecting stamps for more than 20 years and received Awards for my exhibits in State and National Level Philatelic Exhibitions.
Timeline
Senior Manager
AnnexMed Pvt Ltd
03.2020 - 08.2020
Payer Configuration Associate
athenahealth Technology Pvt Ltd
03.2016 - 02.2020
Sr. Process Associate
AGS Health Private Limited
08.2011 - 02.2016
Senior Account Executive
Ajuba Solutions (India) Pvt
04.2005 - 07.2011
CSR/Team Mentor
Proton Web BPO
11.2004 - 03.2005
Bachelor of Commerce -
University of Madras
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