Rama S
Chennai
Summary
To secure a challenging position in a reputable organization to expand my learning, Knowledge and Skills. Completely utilize my training and skills, while making a significant contribution to the success of the company.
Overview
3
3
years of professional experience
Work History
Senior Processing Executive
Cognizant Technology Solutions India Private Ltd.
07.2023 - 03.2025
- Enrolling the Medicare and Medicaid coverages during the enrollment period like Initial enrollment, General Enrollment, Special Enrollment and Open Enrollment through multiple processes
- Enrolling the Member through the QNXT, Info crossing and M360
- Medicare Member Enrollment, Termination, Reinstatement, Adding the Provider with in-Network, Adding Demographics and Adding Pharmacy Data to CVS
- The healthcare provider is probably the most familiar with primary care physicians (PCP), who give you primary care services like Internal Medicine, General Practitioner, Physician Provider, Family Practitioner, etc
- Most health plans have provider networks
- Health maintenance organizations (HMO), Preferred provider organizations (PPO)
- Adding Solo Provider and Group of providers, etc
- Played a pivotal role in expediting team proficiency by guiding all teammates through process on member
- Need to check Patient DOB, SSN, First and Last Name, Mailing Address with given Data Base
- Maintaining Database for Patients with Premium
- Quality check for Internal and External processors
- This role solves problems largely by precedent with referral to detailed instructions/procedures and escalates issues and seeks advice when faced with complex problems
- Takes inventory allocation, Production details, Team huddles and hourly count on a daily basis
- Environment: QNXT, MMW, Iserve, M360, Claims Work flow Management.
Transaction Processing Representative
Accenture
04.2022 - 06.2023
- I worked under a project called sapphire, in that project I worked for a US client (BCBSNC)
- Oversaw Group/members information reconciliation procedures and paperwork
- Enrolling the Group/members into the system
- Ensured integrity of enrollment eligibility
- Setting up the bills for the monthly invoice
- We are handling payment for members and validating the invoice and specimen bill for all members
- Generating the ID cards for the active members
- Generating the contact and booklets for the Group
- Handled and evaluated customer inquiries and complaints
- Directly Handling email chat with the client
- The Transaction Processing Representative processes transactions for relevant business processes in various systems and tracking tools
- Need to check Patient DOB, SSN, First and Last Name, Mailing Address with given Data Base
- Maintaining Database for Patients with Premium
- Billing Error Report & Billing Delinquency Report Premium Invoice Report I will handle this Kind of Report
- Takes inventory allocation, Production details, Team huddles and hourly count on a daily basis
- Environment: Facets, Citrix workspace, Nuxeo, Sharepoint, Salesforce, 834 files, Meet Tool.
Education
BBA - Marketing, Finance, Human Resources, And Operation
Soka Ikeda College of Arts And Science For Women
Chennai01-2023
Skills
Microsoft Office Suite
Presentation design
Email communication
Spreadsheet management
Accomplishments
- Top of the month Award for Four times.
- Trained mote than 20+ team members.
- Assigned the works to the respective processors.
- Conduct Team Huddles on daily basics.
- Conduct Fun activities on every Friday.
Languages
English
First Language
English
Proficient (C2)
C2
Tamil
Proficient (C2)
C2
Timeline
Senior Processing Executive
Cognizant Technology Solutions India Private Ltd.
07.2023 - 03.2025
Transaction Processing Representative
Accenture
04.2022 - 06.2023
BBA - Marketing, Finance, Human Resources, And Operation
Soka Ikeda College of Arts And Science For Women
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