Renuka Moray
Hyderabad
Summary
Results-driven Senior Team Manager with a strong background in Claims Adjudication and Team Leadership at INVENTURUS KNOWLEDGE SOLUTIONS. Demonstrated success in enhancing team performance and client satisfaction through strategic operational improvements. tted to leveraging expertise to drive growth and innovation in a dynamic environment.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Senior Team Manager
INVENTURUS KNOWLEDGE SOLUTIONS( IKS)
HYDERABAD
01.2023 - 12.2023
- Evaluated employee performance, highlighting areas for growth.
- Compiled thorough analyses of team performance statistics for leadership review.
- Led and managed a team of 18-20 doctors.
- Enhanced client management through insights from feedback.
- Delivered quality chart notes for physician appointments promptly.
- Performed root cause analysis to create corrective measures.
- Facilitated ongoing meetings to share business trend insights.
- Increased positive client responses with implemented feedback mechanisms.
Health Claim Manager
Reliance
Hyderabad
11.2021 - 01.2023
- Investigated the adjudication process for Indian health insurance.
- Utilized recommended practices for effective claims handling.
- Performed verification and processing of payments per insured policy.
- Streamlined insurance claims process with expert knowledge.
- Determined necessary actions for efficient claims resolution.
- Elevated team functionality through targeted skill-building sessions.
Senior Recovery Resolution Consultant(clinical Inv
Optum Global Solutions
Hyderabad
09.2015 - 11.2021
- Adjudicated claims to mitigate fraud.
- Acted as a quality buddy to enhance team performance.
- Worked with diverse teams to boost M&R and NICE platform efficiency for cosmos claims.
- Developed thorough process expertise, regularly contributing valuable critique. Reconsideration feedbacks.
- Performed audits on cases handled by the internal team to support calibration meetings.
- Facilitated better calibration meetings by offering vital auditing insights.
- Ensured the team's adherence to state and federal compliance policies, as well as contracts.
- Achieved promotion to senior clinical investigator.
- Received top performer awards.
Homeopathy Consultant
Dr.Batra's homeopathy clinics pvt ltd
Hyderabad
09.2010 - 03.2014
- Educated patients on preventive approaches.
- Conducted thorough explanations of therapy techniques to patients.
- Administered therapeutic treatments utilizing medications and interventions to alleviate symptoms.
- Coordinated efforts with multidisciplinary teams to ensure holistic treatment for patients.
- Utilized specialized equipment for patient assessment.
Education
Bachelor of Homeopathy Medicine Surgery - Homeopathic Medicine
JSPS Homeopathy Medical College
Hyderabad, India03-2009
Skills
- Team Leadership Expertise
- Claims Denial Management
- CPT and ICD-10 Proficiency
- Operational Assistance
- Client Relationship Management
- Inventory Management
- Claims Adjudication Expertise
- Strategic SWOT Analysis
- Root Cause Analysis
- Epic Management
- Basic Data Analysis with Excel and Power BI
Certification
- Certified Scrum Master (CSM)
- Lean six sigma green belt
Languages
English
First Language
Telugu
Proficient (C2)
C2
Hindi
Proficient (C2)
C2
Marathi
Proficient (C2)
C2
Timeline
Senior Team Manager
INVENTURUS KNOWLEDGE SOLUTIONS( IKS)
01.2023 - 12.2023
Health Claim Manager
Reliance
11.2021 - 01.2023
Senior Recovery Resolution Consultant(clinical Inv
Optum Global Solutions
09.2015 - 11.2021
Homeopathy Consultant
Dr.Batra's homeopathy clinics pvt ltd
09.2010 - 03.2014
- Certified Scrum Master (CSM)
- Lean six sigma green belt
Bachelor of Homeopathy Medicine Surgery - Homeopathic Medicine
JSPS Homeopathy Medical College
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