Velmurugan R

Highly knowledgeable Subject Matter Expert with background in managing complex projects, fostering cross-functional collaboration and driving innovation. Possess strong analytical skills, adept at breaking down complex concepts for diverse audiences. Known for improving processes, enhancing team productivity and contributing to business growth. Demonstrated success in leading teams towards the achievement of organizational objectives while maintaining high standards of professionalism and integrity.

• Won 'Spot light Award' for best production and quality.
• Interactive with client through call on a weekly basis.
• Provide key ideas to maintain quality control.
• Organize and interact with team to give new updates in process.
• Motivate team to work as teamwork to overcome production and quality issues.
• Effective in identifying the mails and sorting out the issues immediately.
• Claims Rejection, Clearing house enquiries and denials and appeal management.

• Trained in Health Care Basics.
• Trained in Advanced Excel.
• Trained on MS OFFICE.
• Trained in Client portals for claim Status.

Healthnet, Windows XP, Macess, Citrix, Providing business process support to US insurance support providers, linking client’s policies based on attributes in the client’s internal tool.

US Healthcare

• Reviewing and analyzing all types of Member/Provider complaints.
• Identifying the Issues and classifying as Appeal.
• Allocating/Triaging, Assigning targets to the team.
• Escalating issue to respective department both HCFA 1500 and UB 04.
• Resolving member concerns and satisfying their needs.
• Delivering the output as per the client’s requirement.
• Circulating the status/clarifications, updates, calibration call details through email.