Karthik Reddy
Hyderabad
Summary
Results-driven US Healthcare & Insurance Specialist with strong expertise in claims processing, claim adjustments, denial management, and customer support services across fast-paced BPO and US healthcare environments. Proven track record of handling high-volume claims and case's with accuracy, resolving complex issues, and ensuring compliance with payer guidelines and HIPAA regulations. Adept at analyzing claims, identifying denial root causes, and driving resolution to improve first-pass accuracy and reduce turnaround time. Recognized for delivering exceptional customer service through phone, chat, and email interactions while maintaining professionalism, empathy, and strong communication. Skilled in using CRM tools, RA substantiation platforms, and payer systems to enhance process efficiency and customer satisfaction. Committed to quality, timely service delivery, and continuous process improvement.
Overview
4
4
years of professional experience
6053
6053
years of post-secondary education
Work History
Benefits Administration Services Associate III
CONDUENT
Hyderabad
10.2023 - 11.2025
- Expert in processing claim through Mails,Chat, processing.
- Analyzed claim data to ensure accuracy and compliance through real-time audits process of received information.
- Respond to general benefits inquiries from clients and WSEs via phone, chat, email, or case management systems
- Acquired expertise in healthcare payer processing, contributing to streamlined operations.
- Executed real-time audits on payer processes and Phoenix processing, enhancing process efficiency.
- Worked with cross-functional teams to achieve goals
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Processing benefits-related processes, including employee data updates, benefits reporting, and support for service orders and rehires. Key responsibilities span COBRA administration and compliance, FSA/HSA claims processing and adjudication
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Supported team in height time in processing customer queries on there tickets
- Supporting team in graduation and clarifying doubts while processing
BFSI Customer Service
Tech Mahindra
Hyderabad
01.2023 - 08.2023
- Dedicated and empathetic Customer Service Representative with proven experience in resolving customer issues efficiently and professionally across email, and chat support in healthcare. Skilled in handling high-pressure situations, managing customer expectations, and delivering exceptional service that boosts customer satisfaction and loyalty. Proficient in CRM tools like Ubona, Avaya, Ada AI, Zendesk and communication platforms like Chanty. Committed to creating a positive customer experience by providing prompt, clear, and helpful solutions.
- Maintained an average customer satisfaction score of 95% through timely, empathetic, and effective chat/email responses.
- Used Ubona, Zendesk and Gmail to manage support tickets, track issue resolution, and escalate when necessary.
- Delivered clear and professional written communication while troubleshooting customer issues and guiding them through step-by-step solutions.
- Handled multiple live chat sessions simultaneously, ensuring accuracy and speed without compromising quality.
- Collaborated with internal teams through Slack to resolve customer issues quickly and maintain service quality.
- Responded to 27+ customer emails and chat inquiries daily, resolving issues related to status of claim to healthcare.
- Provided excellent service and attention to customers when face-to-face or through mail and chat support.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Executive Sales Associate
PPS Motors Private Limited Volkswagen
Hyderabad
07.2021 - 02.2022
- Managed daily operations to ensure efficient workflow and customer satisfaction.
- Coordinated with sales teams to align marketing strategies and promotional activities.
- Assisted with customer requests andMaintain Records of all backend Sales & uploading answered questions to improve satisfaction.
- Worked with cross-functional teams to achieve goals.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Maintains enquiry records with the Backend Team
Education
Associate of Science - Computer Data Science & Data Analytics Engineering
LOYOLA ACADEMY DEGREE & PG COLLEGE
Hyderabad Intermediate - MPC
NARAYANA JUNIOR COLLEGE
Hyderabad KENDRIYA VIDYALAYA
Hyderabad Skills
Good knowledge in
-Ubona, Avaya, Ada AI Tool, Zendesk (To track work and maintain queue optimization for ongoing case or tickets)
- RA substantiation, US Health equity Tool for Healthcare ( this tools helps to Resolve in the customer queries through mails,Chat,calls)
- HTML(HyperText Markup Language)
-CSS(Cascading Style Sheets)
-JavaScripts Fundamentals
- Knowledge Regarding in Gits & Gits Hub
Salesforce Administration
- Salesforce CRM
- Cloud Computing
- Data modelling
Languages
- English
- Hindi
- Telugu
- C1
- 1
- B1
- 1
- C1
- 1
Disclaimer
I affirm that all information stated in this resume is accurate, authentic, and verifiable. I am committed to providing any required documentation to substantiate these details.
Hobbies and Interests
- Geopolitics & Global Affairs Analysis
- Home Gardening & Sustainable Living
- Watching Tech, Business & Educational Podcasts
- Traveling and Exploring New Cultures
Personal Information
Languages
English
Proficient
C2
Hindi
Advanced
C1
Telugu
Proficient
C2
Timeline
Benefits Administration Services Associate III
CONDUENT
10.2023 - 11.2025
BFSI Customer Service
Tech Mahindra
01.2023 - 08.2023
Executive Sales Associate
PPS Motors Private Limited Volkswagen
07.2021 - 02.2022
Associate of Science - Computer Data Science & Data Analytics Engineering
LOYOLA ACADEMY DEGREE & PG COLLEGE
Intermediate - MPC
NARAYANA JUNIOR COLLEGE
KENDRIYA VIDYALAYA