RAMACHANDER.S

SUMMARY

Highly experienced and dedicated healthcare professional with 16 years of expertise in healthcare claims management, committed to driving team success, improving operational efficiency, and delivering exceptional results.

PROFESSIONAL EXPERIENCE

SAGILITY, BANGALORE

Current Role: Team Leader Operations

ROLES AND RESPONSIBILITIES:

Team Leader

Lead a team of Medicare claims professionals, overseeing their daily activities

Providing guidance, and ensuring adherence to quality standards and performance metrics

Monitor and analyze key performance indicators, identify areas for improvement, and implement corrective measures

Set clear team goals.

Delegate tasks and set deadlines.

Oversee day-to-day operation.

Monitor team performance and report on metrics.

Motivate team members.

Claim Processor

Analyzing and adjudication of insurance claims through RUMBA AND ECHS applications.

Ensuring assigned weekly target in terms of number of claims produced are met.

Ensuring claims are processed on a ‘turnaround time’ basis.

Taking additional work in case of special project claims.

Ensuring claims are processed as per SLA /minimal defect.

Helping team members in processing complex claims and Error Rebuttals.

Trainer and Auditor

Trained three batches in Dental Orthodontics module.

Have audited the claims handled by employees under probationary period.

Conducting ‘Refresher Training’ to the team when required.

Subject Matter Expert

Worked as a Senior Claim Processor.

Handling rework claims.

Reviewing and processing high dollar claims.

Updating team on new releases/ change in processing workflow.

Conducting ‘Error Share’ sessions.

Helping respective Lead/Assistant Manager in doing Backlog reports, Production reports and Aged reports.

ACHIEVEMENTS

Identified as Monthly achiever – Lead for Quality and Production

Certified from RNL Training Program

Have recognized as ‘Rising Star’ in a team.

Have won spot awards in ‘Inter-State Quiz Competition’

TOP GUN Award. Have bagged Top Gun Award six times in a year for highest Production.

Workaholic Award.

Wall of the fame Award.

Have underwent VPT (Virtual Pool Training) and RNL (Ready now leads) workshops initiated by OD & PM.

Participated in several CSR activities (Visiting orphanage & Govt Schools)

EDUCATION

Bachelor’s Degree -. EIILM UNIVERSITY

Certification – Business analysis - IMARTICUS LEARNING, Bangalore

PROJECT/CASE STUDY CURRENTLY WORKING ON:

Profit Percentage of a Multi-specialty Nursing Home in a month.

Town: Bangalore (North), Mahalaxmi Layout.

Personal Information

Name – Ramachander S

Phone number- 973*******

DOB – 18th May 1983

Residential address - # 2, 5th cross, Parimalanagara, Nandini Layout, Bangalore-560096

Email address – ad1bww@r.postjobfree.com

Languages known – English, Kannada, Tamil, Telugu & Hindi

Marital Status –Married

Passport – Yes

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