Virupaksha Thippeswamy
Bangalore
Summary
Dynamic healthcare professional with 15+ years of experience in US healthcare domain and expertise in the areas of Claims management, denial management, RCM, Enrollment, Provider Credentialing, Benefit Configuration, Member Correspondence, Member Benefit email support, led a strength of 20 folks regarding their overall performance. Always strive to deliver and meet client given SLAs through continuous improvement plans by having an excellent communication, interpersonal, leadership skills to work under challenging and deadline-driven environment.
Overview
17
17
years of professional experience
Work History
Process Specialist
Cognizant Technology Solutions Ltd
05.2023 - Current
- Individuals in this role are Subject Matter Experts who process transactions as well as support team on process knowledge related requirements and activities related to maintaining process documentation. Enable understanding of frameworks through training, drive adherence to process frameworks through audits and update/ maintain knowledge management by performing activities like root cause analysis on errors made by team members. Additionally, individuals may also be required to perform review process role in addition to current role on as needed basis.
- Process specialists support Team Manager/Program Manager with Process and Quality compliance, certification and process improvement activities.
- Individuals in this role are Subject Matter Experts who assist PE/SPE population in clarifying doubts, working on SOPs, process reengineering, process documentation and updates, refreshers, working on cheat sheets, building knowledge repositories, assisting training team in putting together training material for process and so on. Also closely work with Quality Assurance team on errors and putting together CAPA (Corrective and Prevention Actions).
Executive Service Quality - Capability Development
FirstSource Solutions Limited
12.2021 - 08.2022
- Being part of quality and training team, I was responsible for process training for new associates and their OJT, mentoring, refresher training, quality improvement programs, RCA analysis, attrition, retention and discussion with client call on daily basis regarding associates' performance and their certification, test of understanding and sharing daily productivity and quality scores to client as well as management.
- Being responsible for quality and capability development team, I used to interact with clients regarding conflict process scenarios and receiving clarification on specific areas of process workflows. Moreover, I was auditing associates' handled tasks to make sure that they are free from defects. Additionally, I involved in assigning buddy support system within team to perform better in terms of productivity as well as quality.
Senior Process Executive
Cognizant Technology Solutions Ltd
10.2017 - 04.2021
- Managing team inventory and team in absence of lead as well as mangers and sharing ideas to management in terms of automate possible process workflows to increase productivity as well as reduce time taken to handle batches in larger volume situation.
- Involved in attending weekly meetings regarding inventory and quality with client and if we come up with any clarification questions or impediments from team members I used to collect and consolidate queries and send it to client to get appropriate response.
Senior Process Consultant
Hinduja Global Solutions Ltd
06.2007 - 10.2017
- I have worked in domestic BPO voice process for ICICI Prudential project. Later I have moved to international non-voice process which pertaining to US healthcare and learnt different medical terminologies (ICD-10, CPT, HCPC, Modifiers, Contract, Pricing, Revenue codes, AR, Overpayment, Recoupment, Denial and Pend) of healthcare domain.
- Conducting team meetings and attending weekly meetings with client discussing and sharing results. Moreover, I have played role as Gate Keeper for team escalations, CCR review for HDR claims to onshore team.
Education
Bachelor of Arts - English Literature
Sree Siddaganga Arts College
Tumkur10.2001
Skills
- Claim Processing
- Member Enrollment
- Benefit Configuration
- Credentialing
- Medicare
- Medicaid
- Appeal and Grievances
- Overpayment Recovery
Work Preference
Work Type
Full TimeLocation Preference
HybridImportant To Me
Company CultureHealthcare
I have been working for US healthcare domain from last 15+ years and know the terminology, line of business, applications as well as workflow.
If you give me an opportunity definitely make sure adding value to the organization with my best of efforts.
Timeline
Process Specialist
Cognizant Technology Solutions Ltd
05.2023 - Current
Executive Service Quality - Capability Development
FirstSource Solutions Limited
12.2021 - 08.2022
Senior Process Executive
Cognizant Technology Solutions Ltd
10.2017 - 04.2021
Senior Process Consultant
Hinduja Global Solutions Ltd
06.2007 - 10.2017
Bachelor of Arts - English Literature
Sree Siddaganga Arts College