Operations

S. VIJILA ( Vijayalakshmi)

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

Tel: 967-***-****

PROFESSIONAL SUMMARY

Detail-oriented and analytical professional with over 4 years of experience in claims analysis and process improvement. Adept at problem-solving, data analysis, and working with various insurance systems. Seeking to transition into Quality Engineering where I can leverage my strong analytical skills, attention to detail, and process optimization experience to contribute to ensuring high-quality products and processes. EDUCATION

Bachelor of Technology (B.Tech) in Information Technology Gopal Ramalingam Memorial Engineering College, Chennai India 2012

Percentage: 72.3%

12th Grade

Assisi Matric Hr Sec School, Chennai India

2008

Percentage: 67.5%

10th Grade

Assisi Matric Hr Sec School, Chennai India

2006

Percentage: 76%

PROFESSIONAL EXPERIENCE

AR Analyst

MIRAMED AJUBA PVT LTD SOLUTIONS, Chennai

April 2020 – 2024

• Managed and analyzed claims for Durable Medical Equipment (DME) and handled various denial processes, demonstrating strong attention to detail and problem-solving skills.

• Reviewed and corrected denied claims, addressing issues related to modifiers and diagnostic pointers.

• Analyzed patient medical records and history to ensure accurate claim processing.

• Coordinated with insurance companies including Medicare, Blue Shield, Medicaid, and Cigna to resolve nonpayment issues and verify claim statuses.

AR Analyst

ONCOSPARK INDIA PVT LTD, Chennai

January 2016 – March 2020

• Worked on denial management and claim resubmission, improving claim approval rates through meticulous review and correction of errors.

• Verified Explanation of Benefits (EOB) and acted on denied claims by investigating and resolving discrepancies.

• Maintained high performance and consistently achieved targets by effectively managing claim statuses and patient eligibility details.

Quality Analyst

Technoplast technology ChennaiApril 2012 – 2016 : Manufacturing experience Quality Assurance & Testing in Manufacturing : Developed and executed comprehensive test plans and test cases for software applications, ensuring that products met quality standards and customer requirements. Performed both manual and automated testing to identify defects and ensure functionality. Process Improvement: Analyzed and improved quality assurance processes, leading to a 20% reduction in defect rates. Implemented best practices and standardized testing procedures to enhance overall product quality. Quality Assurance & Control: Proficient in manual and automated testing methodologies. SKILLS

• Data Analysis & Problem Solving: Proven ability to analyze complex data and resolve issues.

• Claims Management: Experience with reviewing and correcting denied claims.

• Process Improvement: Demonstrated ability to optimize processes and improve claim approval rates.

• Technical Proficiency: Familiar with various insurance systems and tools for claim processing.

• Communication: Effective in liaising with senior executives and team members to resolve issues and achieve targets.

• Adaptability: Comfortable with learning new tools and adapting to different processes. CERTIFICATIONS & TRAINING

• MS Office Suite: Utilized MS Office Suite (Word, Excel, PowerPoint) for creating reports, analyzing test results, and preparing presentations.

• ERP Software: Worked with ERP software for managing inventory, tracking product quality, and coordinating with various departments to ensure efficient operations.

• Invoice Preparation: Handled invoice preparation tasks, ensuring accurate billing and documentation for transactions

PERSONAL DETAILS

• Date of Birth: 16-11-1990

• Sex: Female

• Languages Known: English & Tamil

• Nationality: Indian

• Marital Status: Married

DECLARATION

I hereby confirm that the information given above is true to the best of my knowledge. Place: Chennai

Date: [Current Date]

Yours truly,

S. Vijayalakshmi

Contact this candidate