Sri Kumar
Chennai,Tamil Nadu
Summary
Seasoned professional with 6+ years in customer service and healthcare as a Subject Matter Expert. Demonstrated success in leadership and management, enhancing team performance, optimizing operations, and ensuring outstanding customer satisfaction. Certified Lean Six Sigma Green Belt committed to continuous improvement and operational excellence.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Subject Matter Expert
Adamsbridge Service Private Limited
Chennai
12.2020 - Current
- Led and mentored a team of customer support executives in the Medical Records Retrieval process, providing guidance and support to help them meet team goals and develop professionally
- Led the entire process from planning to reporting, prioritized tasks, managed team schedules, resolved daily issues, and improved performance metrics (handling time, quality, customer satisfaction) for better efficiency
- Served as the main contact for key US and Canadian clients, managing operational issues and escalations
- Partnered with internal teams to meet client needs, provide customized solutions, and boost revenue growth
- Monitored team performance against SLAs and KPIs, identified areas for improvement, and implemented corrective actions
- Fostered a culture of accountability and excellence, refined processes for efficiency and quality, and established best practices for consistency
- Created and delivered training programs to improve team skills in media operations, ad operations, and client management, fostering a culture of continuous learning and professional development
- Collaborated with HR and administration to build strong relationships and address issues related to policies, compliance, and administrative needs
- Prepared and presented comprehensive quality reports, including Daily Internal Errors, Scorecards, and Management Information System (MIS) reports
- Provided detailed summaries of Customer Experience (CE) performance, findings, recommendations, and updates during business reviews, huddles, and meetings
Team Member
Guardian India Operations Pvt Ltd
Chennai
03.2019 - 12.2020
- Handled incoming calls from US healthcare providers, physicians, and hospitals to verify claim statuses, address denials, and provide detailed explanations of benefits (EOB)
- Assisted providers and policyholders with claim denials, offering guidance on appeals and necessary corrections
- Responded to policyholder inquiries regarding benefits, eligibility, copays, and coinsurance, ensuring clear and accurate information was provided
- Verify claim statuses, eligibility, and coverage details, ensuring prompt and effective resolution of issues
- Managed claim denials and rejections, including Letters of Authorization (LOAs) and account corrections, to ensure claims were processed accurately and efficiently
- Documented actions taken in claims billing summary notes to maintain comprehensive records
- Made necessary corrections to claims based on identified issues and client feedback, ensuring compliance with insurance policies and regulations
- Maintained detailed and accurate documentation of all actions taken, supporting transparency and accountability in the claims process
- Conducted thorough analysis of claims to determine payment status and reasons for denials
- Provided comprehensive explanations to both doctors' offices and policyholders, facilitating understanding of insurance benefits and eligibility
Associate (Medical Records Retrieval)
eNoah i Solution India Pvt Ltd
Chennai
10.2017 - 01.2019
- Conducted outbound calls to medical facilities in the US and Canada, requesting and negotiating the retrieval of specific medical records for life insurance analysis within designated timeframes
- Made regular and persistent phone calls and emails to custodians to ensure the completion of each order, escalating communication as deadlines approached
- Sent proper notices and followed up diligently to ensure records were obtained on time, maintaining a high level of persistence and professionalism
- Managed inbound calls from medical offices and various insurance companies, ensuring Service Level Agreements (SLAs) were met for both inbound and outbound call volumes
- Responsible for the timely completion of individual cases, meeting SLAs for data entry and case analysis activities as per Standard Operating Procedures (SOPs)
- Maintained accurate and thorough documentation of all interactions and activities, ensuring transparency and accountability in the records retrieval process
Education
Bachelor Degree - Computer Science
Vel Tech Arts College
Chennai01.2017
Higher Secondary Education -
Little Holy Angels MHSS
Korattur01.2014
Secondary School Education -
Ebenezer MHSS
Korattur01.2012
Skills
- Leadership and team management
- Training and Development
- Operational Improvement
- Client and stakeholder collaboration
- Project Implementation
- Training and mentoring
- Problem-solving abilities
- Audit reporting
- Resource Allocation
- Stakeholder Management
Certification
- Lean Six Sigma Green Belt (LSSGB)
- Seven Basic Quality Control Tool (7-QC)
Disclaimer
I attest that all information provided herein is accurate to the best of my knowledge. Should I be afforded the opportunity to join your esteemed organization in a leadership capacity, I commit to fulfilling my responsibilities with the highest level of dedication.
Projectinitiatives
- Developed and successfully implemented a Fatal Parameter initiative to reduce continuous errors and deviations within the project, significantly lowering the overall error rate and enhancing process accuracy.
- Re-engineered outdated training materials, developing new, process-specific training resources tailored to current needs. This initiative improved training effectiveness and equipped team members with up-to-date knowledge and skills.
- Efficiently managed and resolved a substantial backlog of tasks resulting from a global outage. Completed all outstanding work with precision, receiving formal recognition and commendation from the client and senior management for exceptional performance.
Languages
Tamil
Native language
English
Proficient (C2)
C2
Work Preference
Work Type
Full TimeWork Location
On-SiteRemoteHybridImportant To Me
Career advancementTeam Building / Company RetreatsCompany CultureWork-life balanceTimeline
Subject Matter Expert
Adamsbridge Service Private Limited
12.2020 - Current
Team Member
Guardian India Operations Pvt Ltd
03.2019 - 12.2020
Associate (Medical Records Retrieval)
eNoah i Solution India Pvt Ltd
10.2017 - 01.2019
- Lean Six Sigma Green Belt (LSSGB)
- Seven Basic Quality Control Tool (7-QC)
Bachelor Degree - Computer Science
Vel Tech Arts College
Higher Secondary Education -
Little Holy Angels MHSS
Secondary School Education -
Ebenezer MHSS
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