Management Health Insurance

Curriculum Vitae

Sunil.m.kulkarni

Flatno.***, Gyan Deep Towers

Moosrambagh, Sripuram Colony

Opp: - Moore Super Market

Dilsukhnagar, Hyderabad - 500036

Email Id: **************.**********@*****.***

Phone No: 990-***-****

____________________________________________________________________

CAREER OBJECTIVE:

Seeking a position to utilize my skills and abilities in an

organization that offers professional growth while being resourceful,

innovative and flexible

Personal Details:-

1. Name : Sunil.m.kulkarni

2. Father's Name : K.Madan Kumar

3. Date of Birth : 23-06-1978

4. Religion : Hindu

5. Marital Status : Married

6. Languages Known : English, Hindi, and Telugu&Kannada

Educational Qualification:-

S.S.C. (Board of Secondary Education)

Intermediate (Board of Intermediate Education)

B.Com (Bachelor of Commerce)

Technical Qualification:-

Typing Lower & Higher Grade

Work Experience:-

Working for DST Worldwide Services India (P) Ltd., as "Senior

Executive" - Transaction Processing in payer side from 01-02-2008 to 13-08-

2011

Company Profile DST Worldwide Services, Hyderabad is a leading BPO Company

specialized in providing IT Enabled Services & Solutions

for major US Clients.

Job Profile

Domain : Health Care

Clients : All Clients

Role : POS (Policy Owner Service) Sr.Executive

Maintaining Medical Privacy & Protected Health Information complying with

HIPAA (Health Insurance Portability and Accountability Act) standards.

Working in accordance with client requirements in order to assure

turnaround time

Roles & Responsibilities:-

Working on Indexing part and Analyzing the document and Assigning to a

particular folder

Handling a designee part

Handling a higher hand process

Like Termination, Coverage Change, Demographics, Billing, POA (Power of

Attorney)

Achievements:-

Got 3 times spot award of Catching the HIPPA Violation i.e., (Health

Insurance Portability Accountability & Act) acted in 1996

Got 1 more spot Award for processing the number of documents of designees

processed 150 documents

Work Experience:-

Project Name : Automation of Business Transaction - RS Unify

Implementation

Client : Hindustan Unilever Limited

Duration : 06-01-2011 to 15-01-2012

> Designation: Analyst

PROJECTS UNDERTAKEN AT CMC:

HUL - QUANTUM HELPDESK :

Project HUL - Quantum Helpdesk

Customer Hindustan Unilever Ltd.

Period From 06-01-2011 to till date

Description Quantum has been developed by TVS Electronics

Ltd. Quantum promises to standardize and automate

all aspects of the sales call to every retailer

in the country. And most importantly enable focus

all our collective might to winning @POP. For

instance all order booking and collections

information would be automatically transferred to

UNIFY with no manual entry in your computers' RS

Unify provides a complete stockiest automation

package that meets every need and fulfills every

whim of a stockiest/dealer. Quantum is a HHT

(Hand Held Terminal/Personal Digital Assistance)

based software. RS Unify covers the entire length

and breadth of the distribution business and

empowers the stockiest to leverage the

much-needed advantage to stay ahead...well ahead

of their competitors.

Quantum is working on windows mobile device

version.

Role/Responsibilities Call follow up and monitoring of tickets till

closure.

On-Floor Support. Issues Follow-up, Escalation

handling & Calls Closing.

Assisting the other team members in solving

various Fatal and Critical Issues.

Training Schedule / Planning and Implementation.

Knowledge Base Management / Sharing / Updates.

Daily Call Review.

Solution Environment Remote management using Citrix Online utility

GotoAssist & Remote Display Control

Tools Microsoft SQL Server Desktop Engine (Database),

DBAMGR2K, Apache Tomcat, Microsoft Active sync.

Highlights Providing technical and functional support for

above mentioned software.

. Software's used are CA SPSD, Citrix

GotoAssist.

. Patch management.

. Coordinating with the client for his day to day

requirements.

Presently working in Inventurus Knowledge Solutions as Senior Associate 02-

01-12 in provider side to till date

. Working on Nextgen software for maintaining Paitient Accounts.

. Working on Different types of Insurances of the Patients.

. Presently working in CPNP Process (Claims Paid Not Posted)

. Sound domain knowledge on the Revenue cycle management (RCM) for US

Healthcare process.

. Adherence to company policies rules and regulations.

. Adherence to HIPPA Guidelines and Policy recommended for the process.

Responsibilities:-

Handling the E-faxes process and analyzing the documents

Maintaining the production and Quality

Conversion of E-faxes on PDF format

Worked for BOA & ERA Process

Worked for Medicare & Medicaid Payments

(Sunil kulkarni)

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