Mayur Naresh

• In 2021, I began my career as a Provider Data Specialist. During my year as a loader in the VACCN process, my outstanding quality and performance led to my promotion to Subject Matter Expert (SME) in December 2022. In this role, I have conducted numerous training sessions for various groups on the process. I have also taken the initiative to enhance the process by creating tools and macros, which improved the team's quality from 96.17% to approximately 99%. Additionally, I have focused on error analysis and performed Pareto analysis to identify key issues. By employing the 5-why methodology, I targeted the most significant errors to uncover their root causes. The tools I developed also increased the team's efficiency by around 30%. Furthermore, I collaborated with onshore partners to establish a standardized training plan for the entire VACCN department. My contributions were recognized when I received the Best Employee of the Year (Super Hero Award) from over 90,000 nominations within the organization, which allowed me to travel to Singapore for a week to represent the company. I also prioritize fostering a friendly and enjoyable work environment by organizing various team-building activities and learning opportunities.

Worked on various provider projects like provider calling to obtain certain information, data management in Excel, maintain and update patient and provider information for their claims and insurance services assigning providers to patients for health care, solving their issues, Addressing provider claims, informing and assigning benefits and plans for member health insurance , processing provider payments and updating member premiums.

Managing multiple batches of new joiners as SME. Supporting them through clarifications, re-fresher training for trainees. Supporting on OGS Audits and Clarifications. Tracking team performance and attendance for over

180 team members. And taking care of IT issues for the entire team,

Projects –

• AEP - Annual Enrollment Period- Enrolling Members to health care plans

• Indexing- Updating member information from medical records like BP readings A1c Readings.

Member personal information Etc.

• Quality Check- having a quality check to see if all the member medical records and information is loaded correctly

• Cosmos- Enrolling members and assigning Primary care doctors, and scheduling appointments

• Fax Research/ Ancillary chase- Reaching out to DR's and obtaining their information like

Address, Fax number, Phone number etc.

• Provided customer service support to customers over the phone.
• Handled customer inquiries and complaints in a timely manner.
• Identified customer needs and provided appropriate solutions.
• Maintained records of customer interactions, transactions, comments, and complaints.