SATHISH E
Bengaluru
Summary
Experienced Senior Process Associate with over 4 years in claims adjudication and US healthcare. Skilled in processing claims accurately, resolving issues, and ensuring compliance with healthcare regulations. Strong problem-solving abilities and a focus on improving workflows and efficiency. Looking to contribute my expertise to a healthcare organization in the US.
Overview
6
6
years of professional experience
Work History
Program Specialist
Fortrea Clinical Development Pvt.Ltd
09.2024 - Current
- Processing US healthcare insurance claims daily wise with quality production with SLA.
- Validation of eligibility criteria and Proof of income documents to verify patients and validate patient billed with correct provider's as per the process guidelines.
- Working for Lilly pap project and analysis of client's fax application and update in system tools as per client requirements.
- Processing Healthcare Fax applications received from patients and providers and working as per process guidelines with accuracy.
- Maintaining Quality and meeting production with 100% accuracy.
Senior Process Executive
Cognizant
08.2021 - 01.2023
- Testing and validation the claim or document as per SOP's and guide line
- Reviewing and resolving the errors
- Reviewing the document work done by the junior executive
- Sending and replying for clarification from client through mail
- Ensuring to achieve the target by the end of the day and Every day send EOD status and product report to the team lead
- Actively cultivate strong workings relationship with colleagues and manager increasing work production.
- Generated monthly metric reports, interpreted results and developed processes and solutions.
Senior Process Consultant Operations
Sagility India Private Ltd
07.2019 - 05.2021
- Worked as consultant process under Post pay and pre pay team
- Process Claim as per SOP and Guideline
- Review the work done by the junior executive
- Acquired the Knowledge related to the project
- Every day send the production and quality report to supervisor and Meeting SLA's production and quality
Education
Master of Science - Applied Mathematics
Bangalore University
Bangalore06-2019
Bachelor of Science - Electronic, Physics, Maths
Bangalore University
Bangalore06-2017
Skills
- MS Excel
- Document Validation and Testing
- MS office
- Problem-solving
- Claim adjustment
- Quick learner
Accomplishments
- Awarded as Top Gun for 100% Attendance, Quality, and high production.
Languages
English
Kannada
Telugu
Accomplishments
- Achieved Quality Award for 100% quality assurance for all the parameters over 6 month's .
Timeline
Program Specialist
Fortrea Clinical Development Pvt.Ltd
09.2024 - Current
Senior Process Executive
Cognizant
08.2021 - 01.2023
Senior Process Consultant Operations
Sagility India Private Ltd
07.2019 - 05.2021
Master of Science - Applied Mathematics
Bangalore University
Bachelor of Science - Electronic, Physics, Maths
Bangalore University
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