Summary
Overview
Work History
Education
Skills
Accomplishments
Languages
Hobbies and Interests
Disclaimer
Place
Personal Information
Timeline
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Madan Kumar R

Madan Kumar R

Bangalore

Summary

Seeking a position where I can apply the knowledge that I have learned and explore my abilities, skills, sense of dedication towards my duties and to excel in field that would facilitate effective and critical solutions for corporate world.

Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience.

Overview

9
9
years of professional experience

Work History

Subject Matter Expert

Cognizant Technology Solutions
Bangalore
03.2020 - Current
  • Company Overview: (US Health Insurance)
  • Verify Member Details,and pay the correct amount
  • Worked on Both Hopital and Medical claims.
  • Experience Claim Adjudication and cashpayment.
  • Daily taking inventory report and sharing with team and clients.
  • Handling Escalation requests.
  • Supporting the team on Audit part.
  • Mentored junior staff members, fostering professional development and knowledge sharing.
  • Provided subject matter expertise during meetings with senior leadership team members in order to discuss potential opportunities or challenges.
  • Working as per client expectations like aging wise clearing inventory.
  • Work as a team and maintain 100% production and achieving 100% quality.
  • (US Health Insurance)
  • Maintained positive working relationship with fellow staff and management.

Senior Claims Processing Analyst

Hinduja Global Solutions
Bangalore
03.2017 - 01.2020
  • Company Overview: (US Health Insurance)
  • Identify the overpayment reason and recouping the overpayment based on the reason
  • Manual review of all adjudication steps on adjusted claims.
  • Taking final decisions on claims overpayment to be recouped or written off.
  • Rework and correcting incorrect overpayment set ups.
  • Providing solution on Customers/Providers inquiries/Disputes on overpayment claims.
  • Analysis of history claims overpayment and submitting the IPAR’s to rework the claims
  • Verifying un-cashed check and correcting the payment to correct provider/address.
  • Validation of primary vs secondary insurance policies and coordination with other insurance, finalizing claims for correct payment as per CMS guideline.
  • Sending emails to the clients and resolving queries though online.
  • Making phone call to provider office for verification of Bill charges and CPT's.
  • Preparation of MIS Reports and shared with managers on weekly basis.
  • Handling client’s escalations when requested by supervisors.
  • Co-ordinating with team members for the work assigned and to see that the deliverables are processed by the within the Target time and the Turn- Around- TAT in the absence of team leader.
  • Prepare and Review Production and Quality reports and shared with clients on weekly basis.
  • Training the new batches on the operational aspects.
  • Provides support as mentor for the new associates after their trainings.
  • Reviewing the work done by the Junior executive.
  • Acquiring knowledge of related areas of the project.
  • Understanding the ethics and compliance of HIPAA.
  • (US Health Insurance)

Education

Degree -

Vijaya Degree College
Bangalore
01.2016

Pre University -

Vijaya Pre University College
Bangalore
01.2013

High School -

Bangalore High School
Bangalore
01.2011

Skills

  • MS-office 2010
  • Outlook
  • HTML
  • Computer Hardware and Networking
  • Good Learning Skills
  • Good Communication
  • Willingness to work with dedication
  • Ability to work in a team
  • Ability to work individually
  • Hard Working
  • Audit support
  • Effective communication
  • Mentoring staff
  • Claims adjudication
  • Payment processing

Accomplishments

  • Received 3 Perfect service Awards for the year 2018 to 2019
  • Received 2 SPOT Awards
  • Received 4 'Top Gun' Awards for the best performance

Languages

  • English
  • Kannada
  • Telugu

Hobbies and Interests

  • Listening music
  • Bike raiding

Disclaimer

I hereby declare that the above information is true and correct to the best of my knowledge and belief.

Place

Bangalore, Karnataka

Personal Information

  • Father's Name: G Rangaswamy
  • Date of Birth: 05/08/95
  • Gender: Male
  • Nationality: Indian

Timeline

Subject Matter Expert

Cognizant Technology Solutions
03.2020 - Current

Senior Claims Processing Analyst

Hinduja Global Solutions
03.2017 - 01.2020

Degree -

Vijaya Degree College

Pre University -

Vijaya Pre University College

High School -

Bangalore High School

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Madan Kumar R