Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Kavita Paul

Kavita Paul

Pune

Summary

As an exemplary employee and trainer with more than 9.5 years of experience, excels in taking on additional responsibilities to meet goals and challenges. An enthusiastic team player with a robust work ethic and advanced complex problem-solving skills. Focused, polished communication skills, and expertise in relationship management and coordination make highly adaptable to changing business environments.

Overview

13
13
years of professional experience

Work History

Transactional Quality Specialist

ALLSTATE SOLUTIONS PVT. LTD
Pune
06.2016 - Current
  • Lead overall transaction quality and ensure adherence to defined SLAs
  • Ensure all processes are compliant from a risk perspective – Quality related aspects
  • Ensure continuous reduction in errors
  • Drive process improvement projects to improve performance
  • Handling Backdated Endorsements on personal Auto policies as per Underwriting Guidelines
  • Identify and communicate metrics
  • Assist the Operations Team up of customer compliant & resolution process for the teams
  • Regular interaction with clients and maintain good relationship
  • Carrying out manual changes on policies in historical period with the help of various tools for better customer service
  • Reading State Rules & Rates laid down by insurer and Insurance Services Office to perform corrective actions on a policy
  • Processing transactions as per various state laws to avoid any compliance issue
  • Auditing transactions carrying huge premiums to avoid any incorrect debit/credit
  • Handling Escalated cases on priority basis
  • Floor Support for speedy & accurate processing of transactions
  • Doing the Root Cause Analysis & CAPA with operations leaders
  • Doing Feedback session with the Team
  • Providing instructive and constructive feedback
  • Provides feedback on trends to operational management
  • Provides accuracy feedback to processors
  • Reviewing medical records as needed for basic information to validate billing information.

Senior Associate

WNS GLOBAL SERVICES PVT. LTD
07.2014 - 05.2016
  • Certification in Six Sigma program through company led workshop and currently playing a role of Quality Auditor
  • Handling responsibilities of Team coordinator to oversee process in absence of manager
  • Attending weekly process business calls/meeting with onshore counterpart to discuss work condition and challenges
  • Supporting onshore trainer in monthly audits
  • Assist in training new staff
  • Eligibility Review to ensure systems are set up in accordance with current eligibility documentation for the processing of claims
  • Participates in communication with Operations management regarding trends in order to improve claims processing accuracy and documented business rules for incorporation into training programs
  • Extensive knowledge of medical terminology, standard claims forms and physician billing coding, ability to read/interpret contracts, standard reference materials (CPT, ICD-10 and HCPCS)
  • Communicate training needs to management as identified through audits
  • Handling New Business, Renewals & Endorsements transactions for multiple processes (Inland Marine, Boiler & Machinery and Commercial Liability) – Travelers Insurance Company
  • Maintaining monthly DTP and conducting monthly assessments
  • Maintaining Inventory and Team Work Efficiency report on Weekly/Monthly basis
  • Provide new coverage/product training to teammates
  • Handling quality audits in absence of Quality Auditor
  • Team huddles, new hire training, Floor Support and Weekly Client Calls
  • Played a role of Backup Subject Matter Expert – Attend Weekly & Monthly Client Calls
  • Certification in Train the Trainer program through company led workshop and successfully cross-trained a batch of 5 people to handle sudden spike in volumes
  • Successfully handled two new product transition
  • Created Daily Work Efficiency Tracker and Error Analysis tool.

Senior Process Associate

EXL SERVICE PVT. LTD
05.2012 - 07.2014
  • Working on rush requests & Escalations as per client requirement
  • Looking after daily work allocation and late items
  • Providing Floor Support whenever required
  • Helping new trainees to understand the process & managing their work
  • Earned more than 18 “Star of the Month” and almost 4 “Best Performer of the Quarter” awards during whole tenure.

Education

PGDM (FINANCE) -

PUNE UNIVERSITY
01.2011

B.COM (ACCOUNTING & FINANCE) -

RANCHI UNIVERSITY
01.2007

Skills

  • Auto Insurance
  • Property & Casualty Insurance Claims
  • Strong Domain Knowledge
  • Staff Training/Coaching
  • Problem Resolution
  • Deadline-oriented
  • Customer service-focused
  • Quality Assurance
  • INTRO 320 AWS
  • MS-Office (Word, Excel)
  • Communication
  • Leadership Skills
  • Organizational Skills
  • Documentation Control
  • Failure Modes and Effects Analysis
  • Quality Management Systems
  • Corrective Actions
  • Product Inspection

Languages

  • English
  • Hindi
  • Bengali

Timeline

Transactional Quality Specialist

ALLSTATE SOLUTIONS PVT. LTD
06.2016 - Current

Senior Associate

WNS GLOBAL SERVICES PVT. LTD
07.2014 - 05.2016

Senior Process Associate

EXL SERVICE PVT. LTD
05.2012 - 07.2014

PGDM (FINANCE) -

PUNE UNIVERSITY

B.COM (ACCOUNTING & FINANCE) -

RANCHI UNIVERSITY

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