Customer Service Insurance

Professional Profile

A skilled analyst with over 5 years of valuable experience in the areas of Business Analysis

(requirement gathering & definition), and claims analysis (the lifecycle of the claim) with

reputed organizations. Implemented solutions using Oracle and Web technologies, which

also provided high international exposure

Most recently worked at ZeOmega Infotech, Bangalore, a Business Analyst for

Healthcare projects and Indian Government Organization, NIC projects.

From July 2006 – June 2008 associated with Cambridge solutions, Bangalore, as a

Business Analyst, in workers compensation underwriting and claims processing.

Responsible for preparing Analysis and design documents for the development of the

application. Recognized proficiency in business process mapping, requirement study (as-Is

/ To-Be), defining the various specifications for application implementation, and client

interaction for resolving concerns.

From October 2003 till June, 2006, was associated EXl Service, Noida as claims Analyst

in Aviva Household Claims processing. Responsible to check claim authenticity and the

entire life cycle of claim. Recognized proficiency in reducing the duration of claim life cycle.

Key Competencies and Skill

Information and Technology Background

Information Technology background includes requirement analysis, design, prepare functional

specification documents, testing, support and interfacing with technical staff, business analyst,

customer service, tech writers, management and customers.

Skill used to develop and maintain business applications.

• Requirements planning and management, requirement analysis (how to develop

and specify requirements in enough detail to allow them to be successfully

implemented by a project team).

• Solution assessment and validation (verify the correctness of a proposed solution,

how to support the implementation of a solution, and how to assess possible

shortcomings in the implementation).

• Business process diagrams with Visio, Study E-R diagrams, MS Word, Excel,

Develop Use Cases, Write Test cases, Data mapping (study the As-Is/To-

Be workflow diagram), Data migration, Interfaces and report generation).

Software Exposure

Languages C, C++, VC++, HTML/DHTML, XML, JAVA

Databases Oracle 9.0, Ms-SQL Server

GUI Visual Basic, forms 9i

Tools & Utilities UML, COM/DCOM, ASP, WAP, MICROSOFT.NET,zope/python

Work Details

June 2008 – October 2008

ZEOMEGA, Bangalore, INDIA

(Public Company; Information Technology and Services industry)

Position: Business Analyst (Healthcare & Office procedure systems)

Health Care Project: CHP (Washington)

Enhance Healthcare product (JIVA) to meet Community Health Plan (Washington)

requirements.

(JIVA is ZeOmega's integrated medical management platform that integrates care

management across the Utilization, Case and Disease Management Continuum.)

Participation includes:

Study the as-is workflow of CHP and map the requirements to JIVA and create a data flow

diagram.

Prepare the business requirement matrix sheet, Do analysis and prepare the requirements

document.

Do an Impact analysis of how the modification affects the exisiting system.

Indian Government Project: Office Procedural System for Public grievances.

Develop and coordinate short- and long-range plans for the Design and

Implementation of Office Procedural system for the Department of Administrative

Reforms and Public Grievances (Ministry of Indian Government).

• Create work breakdown structure. Identify required resources.

• Develop Request for Proposals and cost and effort sheet.

• Interact with client and gather information to develop functional

requirements specifications.

• Study the existing systems of the client and provide a better solution.

• Discuss with the technical teams (developers and database) to

prepare prototypes for clients’ approval.

August 2006 – May 2008

CAMBRIDGE SOLUTIONS, Bangalore, India

(Public Company; 1001-5000 employees; Information Technology and Services industry)

Position: Business Analyst (Underwriting and claims System).

The purpose of this discipline is to evolve a robust architecture for the system based on the

requirements, to transform the requirements into a design, and to ensure that implementation

environment issues are reflected in your design.

• Understanding the business and existing IT applications and designing

a road map for further software development.

• Conducting system study and coordinating with team members for

System Design & Integration, Application Maintenance, etc.

• Mapping business requirements for process enhancements and

translating these requirements into functional specifications

• Assisting internal business partners and technical teams to define and

refine business strategy and supporting operational processes.

• Responsible to prepare functional test cases to test applications

functionality. Assist customer in preparing use test cases for user acceptance.

• Involved in identifying high level business processes using business

models to help redefine business processes and build new systems.

• Involved in preparation of use cases for Worker’s Compensation

insurance policy and claims administration system.

• Do an impact analysis on any changes that may come up in the future.

Review and verify the process flow periodically with the A&D and coding

progress to ensure that there is no gap between the two.

• Reports generation using Congnos tool.

• Building interfaces mainly for payment generation and claims

submission.

• UAT deployment and fixing UAT issues.

2003 - June 2006

EXL SERVICE, Noida, India

Position: Claims Analyst

Aviva is the world's seventh-largest insurance group and the biggest in the UK. It is one of the

leading providers of life and pensions products to Europe and has substantial businesses

elsewhere around the world. Its main activities are long-term savings, fund management and

general insurance. EXL and Aviva successfully migrated and are managing over 70 persons in

the Insurance sector processes, which offer end-to-end outsourcing solutions to meet the

unique needs of Aviva.

Claim examination and adjudications for client Aviva UK Household claims process.

• Responsible to take new claims, process the claims to detect fraud Involved.

• Save Money as Fraud savings and provide GOOD CUSTOMER SERVICE.

• Maintain Quality and adhere to AVIVA POLICY in all communications.

Education

CAET, OUAT, Bhubaneswar, INDIA

Masters degree in Farm machinery and Power (Agril. Engg) 2002

Other Certificates

• Diploma in Advance Computing from C-DAC, completed at SIST (Silverline

Technologies) Chennai from Aug 2001-Jan 2002.

• Training on General Insurance Concepts at EXL Services, Aviva Insurance in-

house training facility at Noida.

• Training on AVIVA Insurance PRODUCT POLICIES and PROCEDURES.

• Certificate course in Software Test Engineering From STAG Software Private

Limited, Bangalore from 3rd July 2006 – 18th August 2006.

•

• Participated in PMP training session arranged at Zeomega Infotech.

References

Date: 06/11/2009

Place: New Jersey

(KADAMBINI)

Contact this candidate