Volunteering in social service activities
Kranti
Team Lead-Credentialing
Hyderabad,TG
Summary
Team Leader experienced in directing activities of workgroups. Develops strategies, provides training, sets goals and obtains team feedback. Excellent interpersonal and communication skills. Big picture focus with excellence in communicating goals and vision to succeed. Problem solver, networker, and consensus builder.
Overview
8
8
years of professional experience
1
1
Certification
4
4
Languages
Work History
Team Leader-Credentialing
Aeries Technology
04.2022 - 12.2024
- Managed a team of approx
- 30 associates and ensure that all key metrics of performance as per the Client SLA are met and exceeded
- Responsible for day-to-day Functioning work
- Regularly evaluated employee performance, provided feedback, and assisted, coached and disciplined staff as needed
- Ensure appropriate actions were taken to resolve members' issues or concerns
- Keep records of member production details, audit reports, dashboards and clarification tracker
- Conducting research and trending the data for all quality errors
- Conducting weekly process knowledge tests to the staff
- Compiles and maintains current and accurate data for all providers
- Create CAQH and NPI accounts for new providers
- Completes provider credentialing and credentialing applications; monitors applications and follows-up as needed
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
- Maintains knowledge of current health plan and agency requirements for credentialing providers
- Sets up and maintains provider information in online credentialing databases and system
- Tracks license and certification expirations for all providers to ensure timely renewals
- Ensures practice addresses are current with health plans, agencies, and other entities
- Tracks license, DEA and professional liability expirations for appointed ASC providers
Senior Software Engineer
Value labs
07.2021 - 01.2022
- Worked closely on 2 projects with development team to write test plans for quality assurance
- Participated in more than 5 projects from the start until the end
- Reduced technical production support workload by 25% by automating scripts for database backup
- Achieved 100% on-time project delivery to meet the regulatory milestone
- Collaborated with cross-functional teams to identify, report, and troubleshoot issues, resulting in 90% customer satisfaction
Transportation Analyst
Amazon
09.2020 - 02.2021
- Optimized transportation routes by analyzing historical data and trends.
- Collaborated with supply chain partners to ensure seamless integration of transportation planning and execution.
- Reduced overall transportation costs with strategic planning and route optimization.
- Enhanced freight capacity utilization through effective load consolidation strategies.
- Managed relationships with carriers, maintaining a reliable network of service providers for various shipping needs.
- Improved on-time delivery rates by implementing efficient scheduling processes.
- Streamlined communication between departments, fostering better coordination and decisionmaking.
- Resolved any issues or discrepancies in shipment documentation, ensuring timely deliveries without penalties or delays.
Claims Associate
OptumRx
08.2016 - 03.2020
- Enhanced claim processing efficiency by streamlining workflows and implementing new software tools.
- Optimized resource allocation by regularly monitoring workload distribution among team members.
- Collaborated with team members to develop strategies for efficient claims processing and improved customer experiences.
- Supported risk management efforts by analyzing trends in claim data to identify potential areas of concern or opportunity for improvement.
- Reduced claim resolution time by improving communication between departments and prioritizing urgent cases.
- Participated in cross-functional projects and initiatives, leveraging claims expertise to support company-wide objectives.
Education
B pharmacy -
Maheshwara College Of Pharmacy
01.2013 - 01.2016
Skills
Team supervision
Teamwork and collaboration
Work planning
Team motivation
Problem-solving
Staff training
Key performance indicators
Performance evaluations
SOP adherence
Service level agreements
Certification
Lean six sigma
Interests
Timeline
Team Leader-Credentialing
Aeries Technology
04.2022 - 12.2024
Senior Software Engineer
Value labs
07.2021 - 01.2022
Transportation Analyst
Amazon
09.2020 - 02.2021
Claims Associate
OptumRx
08.2016 - 03.2020
B pharmacy -
Maheshwara College Of Pharmacy
01.2013 - 01.2016