Saurabh Puri

Transition the process from onshore and the same knowledge transfer deliver in offshore as per the client expectation

Leading successful new business onboarding implementations, communication campaigns, meeting timelines and budget requirements, Coordinating and prioritizing project tasks, manages timelines, maintains project plans and communicates status to Business Owners, Senior Management and Customers as needed, Documenting Standard Operating Procedure (SOP) instructions for all ongoing business and transitioning the project to the Operations team, Work with the customers directly and travel onsite to customer meetings ,

· Act as a SPOC for clients during the transition phase of the projects

Having a US Valid visa till 2025.

Received US Medical & Dental Health Insurance claims from the Participant. Claims will process as per the Participant plan and adjudicate the claim on the basis of the documents. Strong Knowledge of Enrollment forms, Benefit Plan and Contribution process, Appeal Claims, Indexing and FMLA process

• Conduct process reviews for ensuring strict adherence to the process parameters
• Set out quality standards for various operational areas, ensuring a high-quality customer experience while adhering to the SLAs.
• Manage operational transitioning / migration and management of processes

Received US Medical & Dental Health Insurance claims from the Participant. Claims will process as per the Participant plan and adjudicate the claim on the basis of the documents. Strong Knowledge of Enrollment forms, Benefit Plan and Contribution process, Appeal Claims, Indexing and FMLA process

• Conduct process reviews for ensuring strict adherence to the process parameters
• Set out quality standards for various operational areas, ensuring a high-quality customer experience while adhering to the SLAs.
• Manage operational transitioning / migration and management of processes

MIS/ Operational Reporting

• Prepare & present various Weekly / Monthly MIS reports pertaining to process / productivity.

• Monitor team’s performance to ensure efficiency in process operations and meeting of individual & group targets. Provide coaching & training to team members to bridge skill/ knowledge gaps

• Perform goal setting, regular performance review & feedback. Conduct annual performance review. Discuss Individual Development Plan

JOB PROFILE

Joined as a Team member and promoted to Advanced processor in Jan 2008 and promoted to YSA Benefit Analyst (Team Developer). The YSA BA also works with BPO Operations Manager in focus to streamline, automate, and/or standardize the process by identifying issues, quality problems and recommends solutions.

Duties and responsibilities

1. Rework of the YSA Checks claims which customer files again for getting better benefit

2. Doing Testing for the clients for the Upcoming Years for the Eligible and Non-Eligible Expenses included

3. Edits resolved for the Clients, near time, Workflow, Health Plan Data feed, Tuition Eligibility, Wired Commute Eligibility Monthly Reports sends to the client. Transition U.S Process From U.S to India.

Advanced Claim Processor:

JOB PROFILE

· Handled a small Team, Mentoring, Coaching, SOP updates & Training.

· MIS data analysis, Auditing & Feedback, TAT Report, Tracking Overproduction & Underproduction.

· Handled Dental Escalation Cases, Rebuttal calls

· Specialist in Dental Claims (Diagnostic, Preventive, Restorative Services and Orthodontic claims

· To inculcate proper knowledge regarding process & people management within team members.

· Handling rebuttal calls with Orlando team. Active participant in monthly TD Conclave calls with Orlando team.

As a Team Member

1 Responsible for handling insurance work for US Health Care Company. Processing claims of customers residing in abroad (US).
Releasing payment (In Dollars) against the claim filed according to the plan benefit of the customer.

2 Rework of the claims which customer files again for getting better benefit and also doing the Audit claims, Escalated claims.

3 Doing upends claims for the new hire batches, New Update Downloads given with in the team related to the process.

4 Making a Daily production reports, Clients aligned and Solving Queries with in the team.

Achievements and Projects

1. Awarded the ‘Best performer of the Month’ in June 2007 and July 2007 of the team

2. Awarded the ‘Star performer of the Month’ on the Floor in August 2007

3. Handled the ‘Taleo project’ of the company in Oct 2007.

4. Awarded ‘Best performer of the month’ in Feb 2008.

5. Awarded ‘Best processor of the month ‘in Feb 2008.

6. Awarded the ‘Champions Award of the Month’ on the Floor in August 2008.

Awarded for the facilitating training for the New Hires on processes and also involved in mentoring and providing feedback in October 2009

1. Responsible for handling insurance work for US Health Care Company Aetna.

2. Processing Dental claims of customers residing in abroad (US).
Releasing payment (In Dollars) against the claim filed according to the plan benefit of the customer.

3.Rework of the claims which customer files again for getting better benefit .High Dollars claims processed after doing the audit for the new processors

To provide system support to users and support to H.R. Department for making salary, employee portfolios and presentations for various training program's

To provide the technical support to the users who were facing the problem in the computer or Laptop.

Handled 15 member of Team. Call monitoring of each and individual associate, making a Daily Reports, Weekly and Monthly, Barging the calls of the agents on a regular basis and providing them quality feedback.