Selestin Glament Raj A

Experience Summary:

Domain - Enrollment and Billing.

Membership - Accenture / Carelon

* The project is to convert the information received through paper form tool called BPM into electronic format IE3 Maps which is given by client.

* Processing the system kickout health applications manually to the system.

* Accomplishing daily enrollment, plan changes, reinstatement, termination and reviewing the application provided by the end user.

* Keying the application information into Enrollment database provided by the client.

* Gathering the missing information of an application through shared mail box , BPM functions etc. to complete an enrollment.

* Responsible for handing and processing the Codeblue in the system within the TAT of 30 min.

* Processed request received in Shared mail box , PEGA tool and BPM tool received from direct customer, internal and external partners with regard to the queries of health coverage of US Citizens.

* Reviewed and processed premium cheque received from customers into the system.

* Processed refunds to the customers if the customer made an extra payment or out of coverage or is eligible for APTC, CSR and subsidies.

* Reviewed and processed various miscellaneous reports i.e, Address change, Phone no, Dependent addition and termination and other billing reports.

* Reviewed and processed data from history of member data on audit trail screen as per reports received from client.

Contribution:

* Provided training to new associates in Data Capture, Missing information and various billing process.

* Resolving the clarifications raised by the associate.

* Providing audit support to the Audit Team.

* Preparing and sharing Daily production reports to Team.

* Responsible for checking and tracking the daily inventory received in various queues in daily and monthly wise.

* Handling the Data capture and missing information team in absence of SPOC.