T VIVEK
Summary
To work in association with Professional groups who offer me the Opportunity for Career Advancement and Professional growth.
Overview
6
6
years of professional experience
Work History
Benefits Implementation specialist
TriNet
12.2022 - Current
- Works closely with clients to gathering scope & to provide requirements & documenting it, prioritize issues
- Documentation of requirements to prepare the business requirement Documentation Responsible for configuring all the new rate changes, claims information, billing information for new member enrollments
- Supports in user acceptance testing and coordinating of Implementations
- Reporting to project manager & collaborating with the project development team; Responsible for project deliverables, managing deadlines & workflows
- Following the proper methods & standards
- Communicating & representing requirements to stakeholders throughout solution developments
- Managing deadlines, workflow, calls & Emails
- Responsible for completion of project in agreed timeline & Helping clients to understand the progress of project
- Create project documents, & other related material
- Modify and set up benefits that involves multiple changes and updates
- Develop & report on projectbased key performance indicators Deploying completed systems and providing maintenance support Ability to manage multiple tasks/projects and deadlines simultaneously
- Exceptional oral & written communication skill, ability to communication to senior executive level
- Worked on Healthcare plans HMO, PPO, POS, INDEMNITY Plan Enrollment data set up
- Business Analysis
- Basic SQL
- Benefit & pricing Configuration
- US Healthcare (Payer & Provider)
- Basic Knowledge on EDI
Analyst
Deloitte
01.2022 - 11.2022
- Provided timely and effective support to Rippling customers, helping them resolve issues related to the administration of group health and welfare plans
- Responded to customer inquiries through chat, email, and video conferencing, ensuring efficient resolution of customer concerns
- Worked directly with vendors and clients on policies, eligibility, and claims, streamlining communication for quicker problem resolution
- Led customer issue resolution from start to finish, maintaining a high level of customer satisfaction while managing multiple cases in a dynamic environment
- De-escalated complex issues by utilizing platform knowledge and industry expertise, ensuring that issues were resolved in a timely and professional manner
- Collaborated with the Product and Engineering teams to identify customer pain points, contributing ideas for automation and product improvements to enhance the customer experience
- Developed into a subject matter expert for both customers and colleagues, becoming the goto resource for in-depth product knowledge
- Met and exceeded deadlines and service level agreements (SLAs) while managing time effectively in a high-pressure environment
Configuration Analyst
Value Labs
06.2021 - 01.2022
- Managed tasks related to data matching and carrier coordination, ensuring adherence to strict deadlines
- Coordinated with clients to gather necessary information and resolve discrepancies promptly
- Conducted regular audits to identify and rectify data discrepancies, maintaining a high level of data integrity
- Participated in workshops and training sessions to stay updated on industry trends and regulatory changes
- Data Management and Analysis
- Process Improvement
- Health Insurance and Benefits Insurance
- Project Coordination
- Dashboard Development and Management
- Cross-Functional Collaboration
- Communication and Presentation
- Problem-Solving and Critical Thinking
- Innovative Thinking
- Time Management and Prioritization
Senior Associate
Wipro
01.2019 - 07.2020
- End to End Process including Enrollment of Provider and Member, and Adjudication Extending assistance to the supervisor in Inventory Management
- Extending assistance to the supervisor in dealing the issues related to claims that get stuck in pending buckets
- Working on trouble shooting the team escalations
- Actively attending daily KMI (Key Measure Indicator) calls to discuss on pending claims for resolution within TAT
- Providing resolution to the process related queries submitted by associates in mentor log
- Driving team in the area of accuracy to meet the standards of the organization by providing precautions to the Associates regarding area of errors while working on claims
- Claim adjudication and assisting provider by providing appropriate directions, if resubmission is required
- Training the associates from team regarding updates in existing and new projects Approving and denying the payment
- Processing High Dollar claims
- Supporting in inventory reduction
- Auditing claims with delivering the reports
- Data verification of Member and provider where member selection and provider selection will be done as per the company process instructions
- Rework Process on High Dollar Reimbursement Claims
- Data validation will be done
- Participated in Bright ideas call held Annually in project shared Process Improvement Ideas on claims processing time
Education
Bachelor of Science - Statistics
Satavahana University
Karimnagar01.2017
Skills
- Auditing
- Benefits administration
- Billing systems
- Business analysis
- Communication skills
- Issue resolution
- Client management
- Configuration and management
Awards
- RNR Award, Wipro, 06/01/19
- Spot Award, Deloitte, 07/01/22
Timeline
Benefits Implementation specialist
TriNet
12.2022 - Current
Analyst
Deloitte
01.2022 - 11.2022
Configuration Analyst
Value Labs
06.2021 - 01.2022
Senior Associate
Wipro
01.2019 - 07.2020
Bachelor of Science - Statistics
Satavahana University