Narasimha Murthy K R
Bangalore
Summary
Experienced Program Associate at Fortrea with 6 years of experience. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
10
10
years of professional experience
Work History
Program Associate
Fortrea (formerly LabCorp)
5 2024 - Current
- Worked for Lilly Cares Patient Assistance Program, which offers free medications to eligible patients based on program criteria
- Evaluating patient-submitted applications via fax and online application in the customer management system according to program requirements including income and insurance criteria
- Handling Escalation calls to assist patients and healthcare providers, and processing applications over the phone when necessary
- Conducted comprehensive training sessions and meticulous case audits to uphold adherence to industry standards and best practices
- Handle reporting duties as identified by the team manager
- Handle Quality claims processing across multiple products/accounts as per the needs of the business
- Maintained precise and up-to-date records of caller interactions utilizing a customer relationship management system
- Demonstrated ability to consistently meet deadlines with a sense of urgency while delivering quality results
- Intermediate to advanced proficiency in Microsoft Excel, PowerPoint, and Word
- Collaborated with interdisciplinary teams to address Caller’s complaints and escalate concerns when required
- Consistently stayed informed about the processes to ensure the best possible experience for patients
- Ensuring that products and services meet the established standards set by the company
- Process that ensures you're performing according to the standards of your company
- Maintain and evaluate individual and team performance metrics such as quality scores, average handle time
- Team Members need constant coaching, monitoring, and training to enhance their skill set, product knowledge and customer service capabilities.
Program Specialist
LabCorp
03.2019 - 05.2023
- Quickly and efficiently respond to incoming faxes, identify how best to assist
- Conduct insurance verifications to understand if patient’s prescribed therapy is eligible for coverage
- Document results in appropriate tracking system
- Process patient applications and follow the program's specifications to determine their eligibility
- Document results in appropriate tracking system and manage follow ups as appropriate
- Process patient Orders if patients are enrolled and eligible for free drug
- Other duties as assigned
- Conduct insurance verifications to understand if patients prescribed therapy is eligible for coverage
- Possibly coordinate prior authorizations, investigate alternative insurance coverage, or other funding sources on behalf of the patients per the program specifications
- Process patient applications of various complexities and follow the programs specifications to determine their eligibility
- Place follow up calls and respond to enquiries from patients and/or healthcare providers as necessary
- Liaise with partner distributors and pharmaceutical manufacturers to request products per the program guidelines and track shipments
- Coordinate the order and transfer of prescriptions based on their degrees of urgency to specialty pharmacies as appropriate
- Be familiar with the marketplace and the insurance options available for patients
- Educate patients on the available options as appropriate
- Assist with training new team members by shadowing/reverse shadowing them and serving as a data checker by reviewing data entered in the programs tracking system
- Maintain a professional, calm, and friendly demeanor
- Express thoughts and instructions clearly in both verbal and written communication
- Use grammatically correct and concise language.
Program Representative
Labcorp (formerly Covance)
06.2018 - 03.2019
- Quickly and efficiently manage incoming faxes, identify how best to assist
- From program customers
- Conduct insurance verifications to understand if patient’s prescribed therapy is eligible for coverage
- Document results in appropriate tracking system
- Process patient applications and follow the program's specifications to determine their eligibility
- Document results in appropriate tracking system and manage follow ups as appropriate
- Maintain a professional, calm, and friendly demeanor
- Express thoughts and instructions clearly in both verbal and written communication, i.e
- Uses grammatically correct and concise language
- Identify the nature of the request, document faxes and calls information in applicable software systems
- Manage customer inquiries per established procedures, as necessary
- Conduct outgoing calls to obtain any missing information needed to complete program service, or other appropriate information on a case-by-case basis
- Provide clean, complete, and accurate data of information into appropriate software systems
- Manage, organize, and coordinate mailing of all outgoing program related materials per the program specifications
- Other duties as assigned.
Sr Quality Analyst
Hinduja Global Solutions
07.2014 - 02.2018
- Need to do Quality Checks of Claim’s
- Sample selection- Sample audit- documentation of error- Error trend analysis- feedback
- Cross Checking DRG’s, procedure codes and claim forms
- To create and publish regular audit report with management (daily, Weekly, And Monthly) through excel V Lookup and Pivot table and presenting to team
- Adhering to the teams SLA, understanding Quality & Auditing parameters maintain process related reports
- Reviewing the cases was processed with in TAT
- Doing audits for internal and External
- Timely responding clients Emails and escalations
- Preparing the process knowledge test papers so that knowledge gap of the process can be minimized
- Having calibration call with the onshore team and if any update received, updating the same with the team
- Identify the knowledge gaps, process gaps, and conduct feedback and refresher sessions
- Gives constructive feedback to associates and derive action plan, Providing Corrective and preventive actions (CAPA)
- Strong experience of using QC Tool’s and good knowledge in MS-Excel
- Participating team meetings and sharing ideas to improve process and doing follow-ups on every day and Mentor updates and sharing to everyone
- Giving Training to New Joiners and hand handle the team
- Managing the day-to-day activities of the team
- Motivating the team to achieve organizational goals.
Education
Bachelor of Commerce -
M S Ramaiah College of Arts Science and Commerce
Skills
Training and auditing
Capacity planning
Team handing
Escalation Management
Troubleshooting
RCA
Progress Tracking
Awards
- 4 times ACE award for Top performance.
- 3 Quarter of the Employee Award.
- Awarded “Top Gun Award” 9 times by the management team for outstanding performances at the time Open Enrollment.
- Received appreciation for maintaining Quality.
- Awarded “Perfect Service Award” 7 times for implementing new ideas in the project and making it successful.
- Awarded “Busy Bee Award” 1 time by the management team for best performance for three months consecutively.20 - Perfect Experience for the year of 2016-2017.
Timeline
Program Specialist
LabCorp
03.2019 - 05.2023
Program Representative
Labcorp (formerly Covance)
06.2018 - 03.2019
Sr Quality Analyst
Hinduja Global Solutions
07.2014 - 02.2018
Program Associate
Fortrea (formerly LabCorp)
5 2024 - Current
Bachelor of Commerce -
M S Ramaiah College of Arts Science and Commerce