Sirisha Venneti
Team Lead- Operations
Pune
Summary
Supportive team lead with 11.5 Years of experience in Back-office Operational services well known for executing successful. Expert in following detailed skills
· Good knowledge on Insurance process
· Team handling and management Capable of train new hires in process. Experience in processing Medical claims,
· Good knowledge in recognizing issues related to variable deductible, coordination of benefits, carve-out alternate benefits.
· Good Knowledge on payment posting, Charge entry, claims adjudication and processing
· Hands on experience in using IKA claims management software and reliable working experience on the job tasks,
· Good knowledge about HCFA-1500 and UB-04. Experience in APC and DRG pricing of inpatient and outpatient claims using Ingenix WEBSTRAT and CMS IP pricer.
· Having good knowledge on process of over payment recovery from providers.
· Got trained in Medical coding.
· Certified lean six igma green belt
· Good MS Ofice skills
Overview
10
10
years of professional experience
1
1
Language
Work History
Team lead
Sutherland Global solutions
hyderabad
04.2020 - 01.2021
- Team Management, Work allocation, Team Huddles, Queue management, Quality targets Preparing reports for productivity and quality
- Turnaround Time, Root Cause Analysis, Standard Operating Procedures
- Identify process improvement opportunities and communicate to process owners
- Hold regular team meetings with Team Members to ensure that there is constant flow of information and knowledge dissemination – query logs, issue resolution
- Attend all procedural & quality related conference calls with Onshore/Offshore Teams
- Managed schedules, accepted time off requests and found coverage for short shifts.
- Participated in cross-functional team-building activities.
- Worked different stations to provide optimal coverage and meet production goals.
- Took on additional job duties during unexpected backlog, resulting in meeting project target date.
- Trained new team members by relaying information on company procedures and safety requirements.
- Coached team members in techniques necessary to complete job tasks.
Team Leader-tele Calling
LIC (Under Mr. SB Ram)
Hyderabad
01.2018 - 01.2020
- With LIC under MrSB RAM, Member of zonal managers Club for Agents), Team Management, Work allocation, Team Huddles, Managed 10-member tele callers team
- Hold regular team meetings with Team Members to ensure that there is constant flow of information and knowledge dissemination – query logs, issue resolution, Maintaining Records
- Production hours, Shrinkage, Cross Utilization of resources
- Managing inbound and outbound customer calls in a timely manner
- Identifying customers’ needs and wants, clarifying information whenever possible
SME/Sr. Quality Specialist
Optum Global Solutions
Hyderabad
10.2013 - 09.2017
- In Optum global Solutions, Raheja Mindspace, Madhapur, and Hyderabad
- Client Quality is a tier 4 process in Optum insight deals with over payment recovery
- Hyderabad team reviews and validates the overpaid claims and processes the refunds
- Job Responsibilities:
- Team Management, Work allocation, Team Huddles, Queue management, Quality targets of 15-member team
- Preparing reports for productivity and quality
- Production hours, Shrinkage, Cross Utilization of resources
- Turnaround Time, Root Cause Analysis, Standard Operating Procedures
- Leave management, Review daily key operational variables
- SLAs, Quality audits, Error Analysis, Quality Metrics, Calibration Sessions, Quality Reports
- Quality Huddles on Weekly and Monthly basis, Interact with client on process updates
- Error/Issue Logs, SOP revisions
- New Hire Trainings, Coaching, Mentoring, Feedback, Slow Live Audits, Training Plans, Pre-& Post training assessments, Training Need Analysis, Scenario based trainings
- Query resolutions, Process Knowledge Test, Refresher session, Case study
- Preparing Standard Operating Procedures that are relevant to the assigned projects
- Identify process improvement opportunities and communicate to process owners
- Hold regular team meetings with Team Members to ensure that there is constant flow of information and knowledge dissemination – query logs, issue resolution
- Attend all procedural & quality related conference calls with Onshore/Offshore Teams
Sr.Claims Associate
United Health Group
07.2011 - 03.2012
- RahejaMindspace, Madhapur, and Hyderabad
- UHG works on various stages of claims lifecycle with HIPAA regulated standards and mature processes, transaction quality, reporting and analytics, finance and accounting.
Process associate
Apollo Health Street Ltd
Hyderabad
10.2009 - 05.2011
- Apollo Health Street works with the nation’s leading payers, provider network organizations, and third-party administrators to create custom, efficient solutions for their operation.
Process associate
Anion Technologies
Hyderabad
07.2007 - 01.2009
- Anion technologies works for Freedom Health and Optimum based in Florida, USA and America’s First Choice based in North and South Carolina, USA
- The insurance plans from above mentioned insurances are Medicare approved and have around 50,000 members in various plans related to Medicare, Medicaid and Medigap policies
- The claims entry, adjudication, processing and various other back office transactions are done in the offsite location in Anion Technologies, Hyderabad.
Education
Masters of Science - Microbiology
Bangalore University
Bachelors of Science - Microbiology with computer applications
Osmania University
Skills
MS Office-MS Word, MS Excel, MS Power point, DBMS, good internet skills
Accomplishments
- SSY-Lean Six sigma Yellow Belt certified from Exemplar Global
- SSG-Lean Six sigma Green Belt certified from Exemplar Global
- SSG-Lean Six sigma Black Belt trained from Exemplar Global
- ECIL-Excellence in Continuous improvement Leadership from Exemplar Global
Acheivements
· I have been awarded twice with the STAR OF THE MONTH in claims adjudication area during my tenure at Apollo Health Street.
· Received Three STARA, Four Venus Awards Quarterly Sustaining edge Award for outstanding performances during my Tenure at Optum Global solutions.
Timeline
Team lead
Sutherland Global solutions
04.2020 - 01.2021
Team Leader-tele Calling
LIC (Under Mr. SB Ram)
01.2018 - 01.2020
SME/Sr. Quality Specialist
Optum Global Solutions
10.2013 - 09.2017
Sr.Claims Associate
United Health Group
07.2011 - 03.2012
Process associate
Apollo Health Street Ltd
10.2009 - 05.2011
Process associate
Anion Technologies
07.2007 - 01.2009
Masters of Science - Microbiology
Bangalore University
Bachelors of Science - Microbiology with computer applications
Osmania University