PUNITH ANTHONY K

• Managed B2B transaction support for business customers.
• Created Standard Operating Procedures (SOPs) for B2B processes.
• Performed transaction monitoring and fraud prevention activities.
• Investigated transaction-related issues, and resolved customer queries.
• Supported operational teams by acting as a trainer and process expert.
• Worked closely with stakeholders to improve operational efficiency.
• Key Achievements
• Developed Standard Operating Procedures that improved process standardization.
• Recognized as a top performer for six consecutive months.
• Successfully trained and mentored 136 employees in Hyderabad, improving onboarding efficiency and process compliance.
• Supported fraud prevention initiatives through transaction verification and risk identification.

• Process healthcare insurance claims while ensuring complete documentation accuracy.
• Handle member benefits, eligibility verification, and claims-related inquiries.
• Review insurance claims for compliance with internal policies and regulatory requirements.
• Resolve claim discrepancies and provider-related issues.
• Handle appeals, claim reprocessing, and refund adjustments.
• Perform quality assurance reviews to maintain operational accuracy.
• Identify process gaps, and recommend improvements.
• Analyze trends and provide insights for risk mitigation.
• Collaborate with policy, legal, and risk management teams.
• Support workflow improvements by providing feedback on AI-enabled operational tools.

Key Achievements.

• Maintained high accuracy while managing high-volume claims processing.
• Improved compliance through detailed documentation reviews.
• Contributed to operational efficiency through quality assurance initiatives.
• I received appreciation from clients continuously for six months for better assistance and follow-ups.
• Promoted to SME for achieving continuous client appreciation and being the best performer.
• Performed additional tasks such as auditing and agent monitoring for at least three agents per day.