
Consistent professional with substantial experience in Claims industry and expertise in P&C claims. Proficient in MS Word, Excel, PPT. Supervise daily operations. Strong competencies for addressing operational issues and concerns quickly. Organized and proficient in managing inventory, recognize team weaknesses and optimize plans to drive growth. Focused on supporting business management with developing and implementing successful operational and service policies. Highly effective at promoting positive relationships and building capable team. Ready to take new challenges and build success with exciting organization.
People Management, Ops Management, Healthcare Claims, Insurance
Over 20+ years of industry experience in SLA Management, Team Management, Client Management, Quality Management, Transitioning; Training and Development, and Medical Summarization and Transcription.
Presently working with Exl Services as Assistant Manager (L4), Claims Summarization, managing teams of medical professionals (starting from hiring, managing; training, and bringing them on board).
Expertise in channelizing professional goals of associates towards organizational goals.
Strong leadership abilities.
Analyzing volume trends by preparing various reports - TAT management, to measure SLAs and work with teams to improve them. Preparing business review decks, collecting data from various sources to prepare monthly goal sheets, preparing simplified dashboards to help make data driven decisions.
Analyzing team data for team appraisals and ratings.
Vast and in-depth expertise in medical summarization – Played a pivotal role in establishing a new medical summarization process. Started from preparing training material developed with help of onshore team over multiple daily calls, preparing process instructions, establishing quality parameters, training medical professionals. Helping project bring from pilot phase to steady phase.
Proficiency in streamlining business processes, defining continuous improvement processes, accelerating employees’ strengths, and building efficient and quality focused teams.
Effective communicator& administrator with problem solving & organizational abilities.
➢ Involved in Utilization project – goal was to Aim for utilization of each employee by reducing technology downtime, idle time, managing breaks.
➢ Efficiency gain project – Cross trained team members to get maximum output.
➢ Automation project – Shared inputs and had multiple sessions with analytical and automation team to help understand requirements to increase process efficiency.
➢ Pursuing LSSGB & BB
SLA Management
Setting out productivity, quality, and TAT standards for various operational areas, ensuring a high-quality customer experience, while adhering to the SLAs and work processes.
Creating awareness for driving the projects and process improvement strategy & methodology, ensuring maximum operational efficiency.
Analyzing performance and providing valuable feedback as well as charting out plans for improvement in quality and service standards.
Team Management/Training and Development
Maintaining daily dashboard for production and accuracy for team; providing timely feedbacks for improvement.
Carrying out appraisals & performance reviews of teams members & providing feedbacks on areas of improvements.
Conceptualizing & developing training plans and modules for developing multi skilled work force for cross utilization within sub processes for optimum efficiency.
Reporting
Collecting data and preparing inventory reports for TAT management.
Analyzing inventory trends weekly.
Analyzing productivity and quality data of team members to make data-driven decisions and identifying improvement areas.
Preparing business review decks of BAU and training teams; present to higher leadership.
Medical Summarization/transcription
Researching medical documents and summarizing them from the point of view of litigation as well as claims adjudication. • Training medical professionals inmedical summarization. • Proofreading&editingmedical records,includingvisual proofreading, electronic spell check, grammarcheck.