NIKHIL KUMAR
Noida
Summary
A dedicated and results-driven professional with extensive experience in benefits administration and claims management. I am seeking a challenging position where I can utilize my expertise in managing US benefits, coordinating with vendors, and ensuring smooth claims processing. With a proven track record of delivering exceptional service and driving process improvements, I am committed to contributing to the success of an organization in the healthcare industry.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Solution Delivery Analyst
Wipro HR Services India Pvt Ltd
Noida
2022.11 - 2024.01
- Managing health benefits, life benefits, payroll deductions, HSA and FSA contributions, and employment status through daily service tickets
- Managing COBRA high risk process and creation of Beneficiary accounts for eligible dependents.
- Solving queries of CS reps on the spot through genius chat groups to reduce the creation of service tickets, Solving DBP billing issues for LOA Participants and COBRA Participants
- Communicating with vendors and service providers to confirm the coverage status of participants, if needed
- Managing Medicare HRA Benefits process, working on HRA related service tickets and escalation and collaborating with HRA vendors for process updates and requirements in HRA eligibility, discussing on missing data and improvements.
- Working with the onshore team for process improvement, implementing new projects, and testing new implementations
- Attending daily Huddles / Calibration meetings and collaborate with health leaders on ongoing work status
- Provide ongoing colleague coaching and performance feedback verbally and in written form.
- Actively participated in team meetings to discuss product roadmap updates, feature enhancements and upcoming projects.
- Analyze trends and interpret quality data to address areas of concern and take swift action
- Collaborated with technical teams to design, develop, test, deploy and maintain software applications.
- Resolved customer issues in a timely manner while ensuring compliance with service level agreements.
- Working on US payroll ad hoc file reviews, managing Weekly, Semi- Monthly and Monthly payroll files and processing them through EFT for clients.
- Analyzed customer needs to identify process improvement opportunities.
- Documented system requirements, processes and procedures for use by internal stakeholders.
Senior Associate
Capline Services
Noida
2022.04 - 2022.10
- On-boarding new hire employees for our Onshore team at their assigned clinics
- Working on the on-boarding setup of New Hire in HR tool
- Working on payroll and HR related issues for the onshore team
- Working on payroll recon & submission and issuing off cycle e-checks for the employee
- Provider/ Dentist on-boarding and creation of their employment contracts based on information given by Onshore HR Team and CEO
- Working on Health Benefits Plans and Premium of employees who have enrolled into Medical, Dental and STD plans
- Working on New Hire Enrolment for HW benefit for employee's (US Benefits)
- Payroll submission on every semi-monthly payroll submission day
- Training and supporting new team members, maintaining a culture of collaboration with team work.
Benefits Ops Administrator
Wipro HR Services India Pvt Ltd.
Gurugram
2019.04 - 2022.02
- Managing US HW benefits enrolment and determining employee eligibility against their benefits like Medical, Dental, Vision, STD & LTD, COBRA Coverage, DVS, EAP, HSA and FSA contributions
- Solving complex problems of clients through service tickets created by Service team daily regarding their Benefits like New Hire enrollments, Open enrollments, Payroll Deductions, Cobra benefits, DBP billings, Employee status, QSC, FSA and HSA problems etc
- Managing HRIS File daily and communicating with the HR team of clients if there are any discrepancy on HR files
- Updating employee records with all relevant information (Like employment status, geographical location and address, job location, global unit code, Pay rate and standard hour rate, and benefit eligibility drivers)
- Providing chat support to the benefits service team on their problems asked by Client
- Working with the client team to discuss the process and their processing step and updating SOP and requirements
- Administration of Health Benefits and identifying opportunities to improve existing processes, including process design, documentation, and coaching
- Worked as an escalation point for employee benefit queries and made sure the Benefit service team is trained on processes documented to support inquiries from employees that come into people services.
Claims Executive
Care Health Insurance
Gurugram
2016.09 - 2019.02
- Tracking claims status of the customers, feeding correct hospitalization details in software to process the claim smoothly
- Processing cashless claims of the customers and VIP customers and doing Data Entries of the medical billing details in software Like CLAIMS LIVE, EXIMIUS
- Coordination with CRM- team regarding the claim status and providing the exact claim status to customers
- Coordinating with doctors for the denial reason query reasons and conveying those reasons and queries with the Hospital TPA.
Education
Bachelor of Commerce -
Jiwaji University
Gwalior2015-06
Skills
- Service Delivery
- Attention to details
- Escalation Handling
- MS office- Excel, Word
- Leadership
- Vendor Collaboration
- Improving Processes
- Solution Optimization
Certification
- Certification in Compensation Management & Administration
- Hiring and On-boarding Employees with ClickUP Tool
Accomplishments
- Got appreciated from client for providing accurate resolution for a complex workflow query of CSR within SLA. Also got appreciation for the same from business heads.
- Got rewarded for excellent process management within SLA, in the absence of a process owner in quarterly R&R by Wipro management.
Timeline
Solution Delivery Analyst
Wipro HR Services India Pvt Ltd
2022.11 - 2024.01
Senior Associate
Capline Services
2022.04 - 2022.10
Benefits Ops Administrator
Wipro HR Services India Pvt Ltd.
2019.04 - 2022.02
Claims Executive
Care Health Insurance
2016.09 - 2019.02
Bachelor of Commerce -
Jiwaji University
- Certification in Compensation Management & Administration
- Hiring and On-boarding Employees with ClickUP Tool
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