Summary
Overview
Work History
Education
Skills
Languages
Hobbies and interests
Declaration
Timeline
Generic
Sharan S G

Sharan S G

Coimbatore

Summary

As a Process Specialist – Data with a focus on US healthcare claims analysis , I bring extensive experience in data analysis , process optimization , and cross-functional collaboration . Proficient in SQL, AI tools, and Excel , I specialize in extracting and validating large datasets to ensure accurate claims processing in alignment with client-specific guidelines.

Currently, I lead and mentor a team of 25+ associates (FTEs) , providing strategic direction, performance oversight, and hands-on training to drive team excellence. I have successfully designed and delivered training programs for new hires , existing team members, fostering a culture of continuous learning and high performance.

With strong analytical skills, I identify payment discrepancies, generate actionable insights, and offer data-driven recommendations for claim reprocessing. I collaborate closely with Configuration, Regulatory, and IT teams to resolve complex issues and streamline operations. Passionate about leveraging data and AI-driven solutions to enhance decision-making and optimize workflows, I am committed to delivering consistent improvements in claims processing outcomes.

Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.

Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.

Overview

6
6
years of professional experience

Work History

Process Specialist

Cognizant
01.2025 - Current
  • As a highly skilled Process Specialist with expertise in SQL, team management, leadership, and claim analysis, I bring a proven ability to streamline operations, optimize processes, and drive efficiency across business functions. My advanced proficiency in Excel allows me to analyze complex data sets, generate actionable insights, and create detailed reports to support decision-making.
  • In previous roles, I have demonstrated strong leadership in managing and motivating cross-functional teams, ensuring alignment with organizational goals, and fostering a collaborative work environment. My analytical background in claim analysis allows me to identify trends, resolve issues, and improve workflows to enhance overall performance and compliance. I am adept at implementing process improvements and ensuring seamless execution to deliver high-quality outcomes.
  • With a focus on process optimization and data-driven decision-making, I am committed to driving continuous improvement and supporting the strategic goals of the organization.
  • Streamlined communication within the team, leading to better project coordination and timely completion of tasks.
  • Enhanced product quality with rigorous testing and adherence to industry standards.

Senior Executive

Cognizant
06.2021 - 12.2024
  • Designed and executed complex SQL queries in Microsoft SQL Server to extract claims data tailored to client-specific criteria, ensuring precision and compliance.
  • Validated claims processing accuracy against client-provided guidelines, identifying payment discrepancies and compiling comprehensive reports for client approval and reprocessing.
  • Spearheaded healthcare claim data analysis projects using SQL and Excel, delivering actionable insights that supported client decision-making.
  • Proficiently managed institutional (UB-04) and professional (CMS-1500) claims, ensuring seamless processing and adherence to regulations.
  • Collaborated cross-functionally with Configuration, Regulatory, and IT teams to address and resolve backend issues efficiently.
  • Successfully trained and mentored new associates, equipping them with the skills and knowledge necessary to thrive in their roles.
  • Acted as a Subject Matter Expert, leading and overseeing a team of approximately 25 associates. Guided, motivated, and supported team members to achieve organizational goals while fostering a culture of excellence.
  • Contributed to process improvements through data-driven insights and recommendations, enhancing efficiency and operational outcomes.

Process Executive

Cognizant
10.2019 - 05.2021
    • Processed and adjudicated US healthcare claims (medical/Hospital) in accordance with payer policies and client-specific guidelines.
    • Reviewed claim submissions for completeness, eligibility, and accuracy of ICD-10, CPT, and HCPCS codes.
    • Ensured timely and accurate resolution of claims by validating patient details, provider NPI, authorization, and benefit coverage.
    • Identified and flagged duplicate, erroneous, or potentially fraudulent claims during the initial review.
    • Interpreted EOBs (Explanation of Benefits) and applied appropriate adjustments (denials, write-offs, co-pays, deductibles).
    • Met or exceeded daily productivity and quality standards (>98% accuracy) under strict SLA timelines.
    • Maintained compliance with HIPAA regulations and payer-specific rules (Medicare, Medicaid, Commercial).
    • Collaborated with team leads and QA team for continuous process improvement and issue resolution.

Education

BBA - Retail Management

PSG College of Arts And Science
Coimbatore
2019

High School Diploma -

AVB Matric Higher Secondary School
Coimbatore
2016

SSLC

Vimal Jyothi Convent Matric Higher Secondary School
2014

Skills

  • SQL (Microsoft SQL Server)
  • Data Analysis and Validation
  • US Healthcare Claims Processing
  • Advanced Excel (Pivot Tables, VLOOKUP, Data Analysis)
  • Reporting and Visualization

Languages

English
Advanced
C1
Tamil
Proficient
C2

Hobbies and interests

  • Playing Cricket
  • Playing Chess

Declaration

  • I hereby declare that the information provided in this resume is true to the best of my knowledge and belief. I understand that any false information may lead to disqualification or termination of employment.

Timeline

Process Specialist

Cognizant
01.2025 - Current

Senior Executive

Cognizant
06.2021 - 12.2024

Process Executive

Cognizant
10.2019 - 05.2021

BBA - Retail Management

PSG College of Arts And Science

High School Diploma -

AVB Matric Higher Secondary School

SSLC

Vimal Jyothi Convent Matric Higher Secondary School
Sharan S G