Ramesh Kothari

Led team of 60+ quality assurance professionals, including 1 assistant manager and 3 leads, to drive quality standards.

• Oversaw 150+ clients for prior authorization processes, ensuring compliance and addressing potential risks.
• Handled escalations and developed preventive plans to mitigate future errors.
• Facilitated client calls, addressing inquiries and resolving issues promptly to maintain client satisfaction.
• Preparing and delivering quality monthly business review presentations.

• Implemented QA standards and metrics to ensure consistent production operations.
• Monitored production processes for compliance with established quality standards.
• Conducted root cause analysis to identify issues affecting product quality.
• Investigated customer complaints regarding product performance, implementing corrective actions to improve satisfaction.
• Maintained high production quality by promptly identifying and rectifying defects.
• Trained staff on quality control processes, enhancing team expertise and ensuring adherence to standards.
• Prepared reports on quality assurance activities for management review.
• Established key performance indicators (KPIs) to monitor team progress and align efforts with quality objectives.

• Managed denials process, including communication with US insurance, checking claims status, making appeals, and reviewing EOBs.
• Converted denial claims into payments, improving financial recovery.
• Conducted re-audit of team processes, enhancing compliance and accuracy.
• Analyzed and segregated inventory for team members.

• Performing re-audit of team
  Analyses and segregating the inventory to the team members
  Working on Denials Management, Calling US Insurance, Checking Claims
  Status, Making Appeals, Reading EOB's (Explanation of Benefits)
  Converting denial Claims into Payment
• Proposed and implemented ideas to improve team processes and outcomes.
• Completed day-to-day duties accurately and efficiently.
• Collaborated with diverse coworkers to achieve goals and resolve product and service-related issues.

• Working on Denials Management
  Calling US Insurance
  Checking Claims status
  Making Appeals, Reading EOBs (Explanation of Benefits)
  Converting Denials Claims into Payment
• Managed denials by calling US insurance providers and checking claims status.
• Proposed innovative ideas and solutions that improved team collaboration and effectiveness in achieving key objectives.
• Collaborated with diverse coworkers to meet goals and resolve issues, enhancing service delivery related to products.

• Citibank Credit Card Process.
  Sales Process (Outsourcing Citibank Credit Card),
  Providing Information about different types of Credit Cards
  New Products & Services offered.
  Sourcing JetAirways Citibank Credit Cards and Sourcing Citi Bank
  Gold and Silver Credit Cards, Taking Escalation calls.
• Assisted customers with inquiries and resolved issues effectively.
• Oversaw customer accounts and ensured accurate record-keeping in the system, contributing to improved data integrity.
• Guided new team members in customer service protocols and company policies to foster a knowledgeable support team.