Nithin R
Team Lead PDR
Bangalore
Summary
Project management professional with comprehensive background in leading teams to achieve strategic goals. Expertise in coordinating cross-functional teams and driving project success. Known for collaborative approach and adaptability to changing project dynamics.
Overview
2
2
Certifications
10
10
years of professional experience
3
3
years of post-secondary education
Work History
Team Leader - PDR
Carelon Global Solutions
11.2025 - Current
- Developed comprehensive project plans, ensuring timely completion of tasks and delivering client satisfaction.
- Developed project plans using Agile methodologies to enhance team collaboration and efficiency.
- Led cross-functional teams to deliver complex projects on time and within scope.
- Coordinated with cross-functional teams to resolve project issues and mitigate risks.
- Achieved Six Sigma Green Belt certification through CURES methodology training.
- Mentored junior project managers, fostering professional growth and improving project execution quality.
- Conducted regular performance reviews of teams, promoting accountability and continuous improvement practices.
- Analyzed project performance metrics, driving data-informed decisions for future initiatives and resource allocation.
- Met project deadlines without sacrificing build quality or workplace safety.
- Completed Six Sigma Green Belt with CURES methodology.
Senior Quality Control Analyst
Carelon Global Solutions
11.2022 - 11.2025
- Conducted data reviews and followed standard practices to identify effective solutions.
- Managed DCR claims within TAT daily, ensuring timely resolution and compliance.
- Collaborated with cross-functional teams to design and implement process improvements, resulting in increased efficiency and productivity.
- Followed up on onshore review items to prevent age-related issues in claims processing.
- Reviewing the PG account error claims, finding possible rebuttal versions, identifying loops for the errors with RCA, and creating action plans to avoid the same errors in the future.
- Provided internal support for team inquiries and issues.
- Follow up with the onshore review items to avoid the age-related issues in handling the claims.
- Accountable for handling DCR claims within TAT on a daily basis.
- Handling internal support items.
- I worked on the Ceris Project for process improvement.
- Worked on SharePoint for error notifications to improve the operations quality.
- Mentored junior analysts on best practices for quality assessments and reporting methodologies.
- Acted as a supportive lead in the absence of the Team Leader.
Quality Control Analyst
Carelon Global Solutions
10.2019 - 11.2022
- Developed training manuals on claims and conducted refresher training to enhance team knowledge.
- Consolidated the daily production report and published it on a weekly basis.
- Created the EHD master file, which provides a single source for all team members to audit multiple LOBs.
- Managed high-dollar claims post-operations to mitigate process discrepancies.
- Consolidating the daily production report and publishing it on a weekly basis.
Resolver Assistant
Hinduja Global Solutions
04.2018 - 08.2019
- Managed Care-Plus project initiated by direct onshore to ensure compliance and efficiency.
- Reviewed and denied unnecessary billing codes and adjusted DRG based on medical notes, provider requests, and client discussions daily.
- Streamlined communication between departments to improve workflow efficiency.
- Checked documentation for accuracy and validity on updated systems.
- Trained junior associates on best practices for claims assessment and customer service protocols.
- Supported team objectives in fast-paced environment by facilitating collaboration and communication.
- Conduct process knowledge tests, create an error repository, and onshore teams.
- Contributed to team objectives in a fast-paced environment.
Senior Claims Associate
Hinduja Global Solutions
12.2016 - 04.2018
- Led cross-functional teams to streamline the claims processing workflow, enhancing efficiency.
- Implemented process improvements that reduced claim resolution times and increased customer satisfaction.
- Mentored junior associates on best practices in claims assessment and customer service.
- Analyzed complex claims to determine validity and compliance with policy guidelines.
- Developed training materials for new hires, ensuring consistency in claims handling procedures.
Education
Bachelor of Commerce - Accounts and Finance
Tunga Mahavidyalaya - Kuvempu University
Bengaluru, India 06.2012 - 06.2015
Skills
Business process modeling and analysis
Data analysis and visualization
Business intelligence and reporting tools - Tableau, Power BI, MS Office, SharePoint
Requirements gathering and documentation
Process improvement
Tally ERP 9
Innovation management
Project planning and development
Certification
Business Analyst - Master Program
Certificate ID: 90999141
DECLARATION
I hereby declare that the above written particulars are true to best of my knowledge and belief.
Place: Bangalore
Date
Timeline
Team Leader - PDR
Carelon Global Solutions
11.2025 - Current
Senior Quality Control Analyst
Carelon Global Solutions
11.2022 - 11.2025
Quality Control Analyst
Carelon Global Solutions
10.2019 - 11.2022
Resolver Assistant
Hinduja Global Solutions
04.2018 - 08.2019
Senior Claims Associate
Hinduja Global Solutions
12.2016 - 04.2018
Bachelor of Commerce - Accounts and Finance
Tunga Mahavidyalaya - Kuvempu University
06.2012 - 06.2015