Shivali Bhat

**** ********* **, ******, ***** ***27 480-***-**** ad26a7@r.postjobfree.com

To be multi tasked through continuous learning and dedication exploring my potential, skills and earn exposure by working on challenging assignments. Eager to work diligently to serve on my own in the position as well as a team member.

Education

Completed Masters in Computer Application: UP Technical University,U.P, India in June 2007

Completed Bachelor in Computer Application: Jiwaji University, Gwalior, M.P in May 2004

Finished my Internship from IBM Academic Initiative, Project Invite in June 2007

Project : Job Portal

Details: I have developed the project for job seekers, where applicants can make their profile by registering and can look for the job by uploading their resumes.

Key tools used: MYSQL, HTML, JAVA

Skills: MS Office, Citrix (AVD), QXNT, Multitasking, HTML, SharePoint, One Note

Experience

Cognizant Technology Solutions, Arizona

Project: Molina Healthcare of California

September 2022 – Present

Quality Process Auditor

Develop a complete understanding of the Credential process.

Achieve SLA on time.

Raise Process related issues / concerns on time with process team.

Participate in meetings with management, reviewing the progress of the audits.

Contribute to and participate proactively in knowledge sharing sessions with the team.

Audit enrollment applications and make a report of all the errors and identifies the potential flaws in the system.

Verify and check Enrollments in Medicare plan are processed correctly under Molina Healthcare plan, Centers for Medicare & Medicaid Services (CMS).

Verify Application in QXNT.

Participate in weekly team calls, discussing the errors and discussing the process of improvements if needed.

Participate in project and organization initiatives led by the Delivery leadership.

Complete Enrollment or Disenrollment / query transactions in queue within specified turnaround time.

Audit Transaction Reply Codes (TRCs)

Audit different TRC codes in QXNT, that are processed by the team and verify details in CMS.

Verify the correct process is followed per JOB Aids.

Check the internal system is updated accurately as per the TRC submitted and applicable to the beneficiary.

Check the Demographic details match the CMS for all the TRC and correct letters are send to the members regarding their Medicare benefits.

Enrollment Associate (Cognizant Technology Solutions)

Project: Molina Healthcare of California

Add and Verify member’s credentials in the Molina Healthcare portal in Medicare plan as the application is received.

Process each Medicare Enrollment requests in a timely and accurate manner in compliance with state regulations.

Escalate any problems or concerns to the supervisor and check to ensure their enrollment is complete.

Promptly process each member’s Enrollment request that comes online or through the Sales team.

Help ensure all Enrollment process is delivered in-line.

Ability to work with very high-volume enrollments.

Work on state portals to check Medicare and Medicaid Eligibility and Enroll members in state portal when required.

Participate in regular scheduled meetings related to enrollments, projects and document discussion points and action items.

Assistant Teacher Primrose School of Valley Ranch Irving, TX

August 2022 – September 2022

Spend everyday building relationships with kids.

Work with co-teacher to implement the schedule plans from the curriculum.

Maintain a well-kept classroom that encourages children to create, explore and make decisions and self-confidence.

Discover what works best for each child as they learn and grow every day.

June 2011 – March 2012

Customer Representative Elixir CT Noida, India

Elixir CT is at the forefront for providing mobile and IT solutions to diverse Indian and global companies. High-level architecture provides flexible easy-to-use solutions that empower the management and optimize productivity of employees.

Responsibilities:

•Communicate with customers through telephone, emails, organize and manage customer data, presenting relevant information.

•Resolved Customer problems related to product, explaining them the best solution and follow up with them if needed.

•Check and maintain Customer records in database.

•Maintained Customer reports on a Monthly basis.

June 2007 – September 2009

Software Programmer Indiamart Intermesh Ltd Noida, India

Indiamart is India’s largest online B2B marketplace, connecting buyers with suppliers. It has developed an integrated solution delivery framework which incorporates B2B marketplaces, internet technology and industry knowledge.

Responsibilities:

Hands on experience in converting Customer’s Static Product Catalogs to Dynamic Product Catalog using Perl/SQL used for B2B Portals.

Created more than 100 Product Catalogues.

Implementation of new procedures and methods to reduce errors, improved user experience and customer satisfaction.

Customized existing products for clients enhancing user interface and as per consumer needs.

Analysis of the requirement and created architectural representation of the application.

Created and deployed new application modules and performed various testing procedures required.

Fixed bugs in the application.

Volunteer Work:

Work as a Lead in Sewa international Family Services

Sewa International, Dallas, TX (Feb’20 – Present): Sewa International is a Hindu faith-based, humanitarian, 501(c) (3) nonprofit service organization.

Sewa International helps seniors, the homeless and many needy families by donating blankets and organizing food collection drives to help families.

Prepared Spreadsheet, maintaining details regarding the total donation received.

Assist other volunteers with different locations to drop off items.

Assist with fundraising activity.

Performed other related duties as needed.

Volunteer in Sewa International Family Services: Sewa International has developed and organized the Family Services program across the cities. I have been working as a Lead to help people who need immediate help in situations such as sickness, health care guidance, and other family emergencies.

Voice of Hope Ministries, Dallas, Texas (Feb’21-Jul’21):

Voice of Hope is a non-profit Christian school care organization operating in Dallas, Texas.

Extra-Curricular Activities - Book Club (Online & In-person) Assisted and ran an online and in-person Book Club along with Art & Craft activity for kids (kindergarten – 3rd grade) once a week.

Hobbies: Volunteer, Draw & Paint, Cooking, Travelling.

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