Shivnesh Reddy Gopi Reddy
Hyderabad
Summary
Results-driven Senior Process Executive specializing in DME claim processing and issue resolution. Expertise in eClinicalWorks and EPIC software enhances capabilities in resolving complex issues and training staff. Strong relationship-building skills ensure exceptional customer support and satisfaction.
Overview
5
5
years of professional experience
Work History
Senior Process Executive
Enovis healthcare
Hyderabad
04.2026 - Current
- Finding new Trends in denials to resolve towards payments.
- Demonstrated respect, friendliness, and willingness to help wherever needed.
- Identified issues, analyzed information, and provided solutions to problems.
Senior Process Executive
Cognizant
Hyderabad
02.2025 - 04.2026
- Processed DME CMS-1500 claims and resolved issues for clients Medtronic LLC and DJO LLC, ensuring compliance and client satisfaction.
- Trained new joiners on DME CMS-1500 claim workflows and system navigation, enhancing their onboarding experience and operational readiness.
- Provided customer support in a voice process using IDX (Athena) and DataWorks for real-time data access and accurate call documentation, improving overall service quality.
Senior Process Executive
Optum Healthcare
Hyderabad
02.2023 - 09.2023
- Executed day-to-day duties with accuracy and efficiency to support operational goals.
- Extensive hands-on experience using eClinicalWorks (eCW)
- Managed over 365 days ageing claims daily to ensure timely resolution and compliance.
- Performed daily tasks to uphold workflow efficiency and meet processing deadlines.
- Worked as a Claims Associate handling professional (CMS‑1500 ) for Palmetto Clinic Foundation.
Trainee-Process Associate
AGS HEALTHCARE
Hyderabad
09.2021 - 02.2023
- Resolved physician billing claims using EPIC software at AGS Healthcare, achieving accuracy in processing and timely resolution of issues.
- Contacting insurance providers and keeping track of claim statuses to determine overdue patient account balances and take the necessary action.
- Worked as a Claims Associate handling professional (CMS‑1500) for Cleveland Clinic Foundation.
Education
Bachelor of Commerce - Computer Applications
Aurora Degree & P.G College
Hyderabad03-2020
Intermediate-MEC
Sri Chaitanya Junior College
Hyderabad06-2017
SSC
New Horizon High School
Hyderabad03-2015
Skills
- DME claim processing
- CMS-1500 claims
- Claims management
- eClinicalWorks usage
- EPIC software navigation
- Data analysis
- Issue resolution
- Problem solving
- Time management
- Multitasking
- Decision-making
- Client relations
- Relationship building
- Team training
- Customer support
Accomplishments
- Top Performer for 2 Quarters at AGS Healthcare.
- Top Performer for Production and Quality At Cognizant.
- I have been entrusted with delivering training sessions for new joiners at the client end.
Timeline
Senior Process Executive
Enovis healthcare
04.2026 - Current
Senior Process Executive
Cognizant
02.2025 - 04.2026
Senior Process Executive
Optum Healthcare
02.2023 - 09.2023
Trainee-Process Associate
AGS HEALTHCARE
09.2021 - 02.2023
Bachelor of Commerce - Computer Applications
Aurora Degree & P.G College
Intermediate-MEC
Sri Chaitanya Junior College
SSC
New Horizon High School