Vijesh Venugopal
Hyderabad
Summary
Experienced Product Owner with a detail-oriented and thorough approach to defining requirements, outlining specifications and working with team members to bring to life high-quality products for customers. Good planner and problem-solver with in-depth understanding of healthcare insurance products. Ready to offer 14+ years of experience and take on a dynamic new position.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Associate Manager Product Management
Carelon Global Solutions
11.2018 - Current
- Liaison between business and IT teams to refine the product and incorporate features based on business demands for Pega Smart Claims started Elevance on a road to transforming claims – the center of complexity for health plan operations.
- Interacted with internal stakeholders as voice of customer.
- Worked on feature development and code implementation on front-end web applications, back-end API services, API portal and API gateway capabilities.
- Liaised with product team and development team to help break down requirements.
- Broke project into epics and implementable user stories.
- Owned and prioritized product backlog.
- Attended Agile ceremonies, demos and production proving activities.
- Oversaw entire product deployments from vision and creation to rollout and delivery.
EDI Business Consultant
TCS Adibatla
11.2015 - 11.2018
- Managing healthcare business for one of the largest clients operating more than 14 states in the USA.
- Handling 4 SME's and 36 associates which include EDI implementation, WEB enrollment, Group setup and EDI support team.
- Monitor daily/monthly inbound & outbound file transmissions to ensure accurate and successful transfer of enrollment data to the carriers.
- Co-ordinate, support, and engage in software testing and quality assurance efforts with external customers and vendors of XML and EDI transactions (834).
- Coordinate with IT staff and carriers to identify and resolve 834 enrollment processing problems.
- Translate statutory data reporting and EDI requirements into functional and technical design documents.
- Conduct interviews with business users and customers and define EDI requirements.
- Maintain functional and technical documentation related to Enrollment EDI transactions and reporting.
Subject Matter Expert
Cognizant Technology Solutions, CTS
04.2012 - 11.2015
- Helped the US hospitals / physicians in recovering the AR (Account receivables) pending from a Healthcare service rendered to the patient.
- Followed with US based Insurances to collect the pending amount on the Healthcare.
- Communicated with insurance companies to ensure accurate information is received.
- Investigated problem accounts resolved for payment/Insurance verification.
- Participated in revenue cycle processes, working to maximize profitability and increase revenue.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Knowledge Management- Train new joiners on the process and maintain knowledge Management database.
- Active participation in the process/knowledge transitions from business to Cognizant center.
- Ensure process documentation is up-to- date and updates are shared with the team members on regular basis.
- Documentation: review all process changes to improve process quality of the team.
Business Process Associate
ACS Xerox
06.2010 - 07.2011
- Helped the US hospitals / physicians in recovering the AR (Account receivables) pending from a Healthcare service rendered to the patient
- Followed with US based Insurances to collect the pending amount on the Healthcare Communicated with insurance companies to ensure accurate information is received Investigated problem accounts resolved for payment/Insurance verification
- Strive to suggest creative solutions aimed at improving productivity levels and working conditions.
- Responsible for enhancing and developing billing dept.
- Undertaken back-office processing/ analytical activities
Application Support Engineer
Atlanta IT Solutions
08.2009 - 05.2010
- Provided technical leadership, guidance, and assistance to the support staff.
- Worked with management to develop and implement strategic plans, initiatives, and direction.
- Worked with internal teams to resolve issues.
- Responsible for personal and professional development of subordinates.
- Developed individual goals and objectives of the staff for reports and documentation.
- Planned and evaluated the work of professional, technical, and other support staff.
- Provided ongoing industry training to employees to keep them up to date on the latest products, technology and resources available to them and our customers.
- Traveled to rep territories for training and job-related meetings.
Server Support Engineer
Alkali Soultions
05.2007 - 05.2009
- Level 1 technical support
- Sales and interaction with the clients around the world.
- Billing and invoicing.
- Team -clients management.
- Monitoring the servers and websites of the clients.
- Assisting in front office management and office administration if necessary.
- Conduct feedback survey periodically.
Education
Bachelor of Science - Computer Applications Development
CMS College of Science And Commerce
Coimbatore06-2006
Skills
- Agile frameworks
- Stakeholder relationship management
- Scrum methodology
- Product backlog
- Team management
- Analytical and Critical Thinking
- Training and Development
Certification
MCP - Microsoft Certified Professional
Scaled Agile Product Owner/Product Manager
Certified Scrum Master
Lean Six Sigma Green Belt
Technical Profile
- Microsoft Office
- JIRA
- Confluence
- Healthcare Revenue Cycle Management
- EDI Transaction set: 834/837
Languages
Malayalam
Proficient
C2
English
Proficient
C2
Hindi
Intermediate
B1
Timeline
Associate Manager Product Management
Carelon Global Solutions
11.2018 - Current
EDI Business Consultant
TCS Adibatla
11.2015 - 11.2018
Subject Matter Expert
Cognizant Technology Solutions, CTS
04.2012 - 11.2015
Business Process Associate
ACS Xerox
06.2010 - 07.2011
Application Support Engineer
Atlanta IT Solutions
08.2009 - 05.2010
Server Support Engineer
Alkali Soultions
05.2007 - 05.2009
Bachelor of Science - Computer Applications Development
CMS College of Science And Commerce