R. Suryapraveen
SME At Cognizant
Summary
Results-driven Subject Matter Expert (SME) with over 3 years of experience in US Healthcare claims adjudication and operations within Cognizant Technology Solutions. Skilled in process optimization, team coaching, quality compliance, and production management. Proven ability to improve operational efficiency through cross-training strategies and data-driven decision-making. Strong analytical, communication, and stakeholder management skills with expertise in payer-side auditing.
Subject Matter Expert and trusted advisor skilled in research, analysis and examination of company technology and standard operating procedures. Interface and collaborate with clients and internal team members, providing consultative enhancement recommendations based on industry research. Improve existing processes, procedures, technical enhancements, resource requirements, and stakeholder engagement procedures to align with strategic goals.
Overview
4
4
Certifications
4
4
years of professional experience
Work History
Subject Matter Expert (SME) – US Healthcare Process
Cognizant Technology Solutions India Pvt. Ltd.
01.2022 - Current
- Manage claim adjudication processes ensuring delivery within defined turnaround time (TAT).
- Coach and mentor associates to improve productivity, accuracy, and performance standards.
- Plan inventory allocation and support operational workflow optimization.
- Conduct quality follow-ups and implement corrective action plans.
- Support onboarding and training of new associates during ramp-up phases.
- Prepare and share operational reports ensuring compliance with internal standards.
- Review process documentation periodically and recommend improvements.
- Perform payer-side auditing for professional and institutional healthcare claims.
- Handle mental behavioral health claims including manual calculations, denials, payments, and high-dollar claims.
- Mentored junior team members, contributing to their professional growth and development.
Education
B.Com - Computer Applications
Dr. SNS Rajalakshmi College
01-2021
Higher Secondary Certificate - undefined
State Board
01-2018
SSLC - undefined
State Board
01-2016
Skills
Power BI
Microsoft Excel (Pivot Tables, VLOOKUP, XLOOKUP, Charts)
Training and mentoring
Strategic thinking
Creative solutions
Strong analytical skills
Accomplishments
- Received multiple Rewards & Recognition awards from organization and onshore stakeholders.
- Contributed to successful delivery of new onshore projects resulting in additional business opportunities.
- Recognized for strong client collaboration and operational excellence.
Certification
Certified Process Trainer – HCSC Client
Core Competencies
- Claims Adjudication & Auditing
- US Healthcare Operations
- Process Improvement & Compliance
- Team Coaching & Mentoring
- Production & Inventory Planning
- Quality Management
- Data Analysis & Reporting
- Client Coordination
Timeline
Subject Matter Expert (SME) – US Healthcare Process
Cognizant Technology Solutions India Pvt. Ltd.
01.2022 - Current
SSLC - undefined
State Board
Higher Secondary Certificate - undefined
State Board
B.Com - Computer Applications
Dr. SNS Rajalakshmi College