RESUME

PRATHAP A

Location:

No:***, Annanagar *st cross street,

thirukkachur, S.P Koil, kancheepuram Mobile: +91-994*******

Pin - 603 204. OBJECTIVE:

Seeking a Challenging Career in the health care industry and to contribute my skills and talents in managing the Organization to achieve its goal.

ACADEMIC QUALIFICATION:

COURSE

YEAR

INSTITUTION/COLLEGE

UNIVERSITY/BOARD

B.COM (General)

2010- 2013

T.M.G COLLEGE OF ATS & SCIENCE

MADRAS University

H.S.C.

2008-2010

GOVT Higher Secondary School, S.P Koil

State Board of Education

S.S.L.C.

2007-2008

GOVT Higher Secondary School, S.P Koil.

State Board of Education

WORKING WITH ROYAL ENFIELD :

I Was worked in royal enfield pvt ltd as store keeper for two years.(2015 – 2017)

WORKING WITH FIRSTSOURCE:

Current Role:

I was worked as Senior Customer Service Associate in Firstsource Solutions Ltd, Chennai from Feb’15 2017 to 7th May 2019

I Have an experience of two projects in healthcare

Project: 1. UHG CART

Serving as Healthcare claims Adjudicator.

Verification of Patient/Member contract status.

Identifying the Duplicate/fraudulent claim.

Working towards in exceeding clients SLA in terms of Quality and Productivity.

Take initiatives and involve in acting TL activities.

Processing and adjudicating medical claims as per policies and Procedures/business line of the client. Coordinating the benefits of the subscriber with federal/other insurance. depending on the order of coverage

Taking decision for payment and denials..

Project: 2. QAA (Quality Assurance and Analyst)

Serving as Healthcare claims Adjudicator.

Analyzing the sold policy Documents with Medical Insurance documents.

Identifying the Error’s through the Audit.

And inform Correspondent Insurance Company Manager to Correct the Error Field.

Finally We need to check whether the patient has received the medical insurance facilities or not based on the rules and regulation of medical insurance.

ACHIEVEMENTS IN THE CURRENT ROLE:

In daily basics I give 120% production with 100% quality.

Enhanced knowledge to expertise in the domain knowledge.

Involved in trouble shooting.

I got a three time’s All ROUNDER award.

Every month I got FE rating in 30% parameter.

Till date I did not get any internal and external errors.

TECHNICAL SKILLS:

Operating System : Windows XP, Windows 7, Windows 8&10 and basic linux.

Applications : Microsoft (Word, Excel, PowerPoint, Access)

: TALLY ERP 9

STRENGTHS THAT CAN BE LEVERAGED IN THE NEW ROLE:

Fast learner and grasp the recent updated and help other team members. Flexible enough as per priorities.

Put extra effort to complete the team task.

Well organized in priorities to be completed.

Volunteer to take additional and interesting tasks.

Well planning and organizing work.

Time Management in completing the Task as per Client requirement.

Role model to the entire team.

PERSONAL PROFILE

Name : Prathap A

Father Name : Anbalagan.

Date of Birth : 13/09/1993.

Gender : Male.

Languages Known : English & Tamil.

Permanent Address : No:120, Annanagar 1st cross street,

thirukkachur, S.P Koil, kancheepuram

603204

I hereby declare that all the information furnished above is true to the best of my knowledge.

Place : Chennai Your’s sincerely

Date : PRATHAP A

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