Business Development
Resume:
Thinakar S
US Healthcare Process specialist/SME
Door No: 52, Sirram Nagar, Opposite to Aaramba Sugathara Nilayam
Edayarpalayam, Kuniamuthur, Coimbatore - 641008
***********@*****.***
SKILLS
T100 & T200 in US Health care/Health Insurance Domain Training (Internal).
HIPAA, Claims Analysis, Team Handling, Client Handling.
Claims Adjudication/Processing Payer and provider data validation.
Quality, Lean.
People Management
Certification
The fundamentals of Digital Marketing, certification ID: GM9 QEC Y3L
Google Analytics for Beginners.
EXPERIENCE
Infosys BPM, Bangalore- Process Specialist/Subject Matter Expert
April 2018 - PRESENT Healthcare Payers /Health Insurance – Claims Analysis and Claims Adjudication
●Talent & People management: Support TL to ensure high E-sat, Daily Huddle.
●Sub - Group Head Handling small team.
●Publish everyday production report using excel pivot and charts.
●Assign works to the team and monitor the inventory to make sure assigned works are completed on time.
●Transition coordination: Conducts training for the team IN ORDER to ensure the right skilling on process/Domain.
●Provides Inputs on processes/business to the team to ensure delivery predictability, Dollar saving, Risk reduction.
●Conduct QA programs-RCA, SOP, TOU, Transition Methodology to contribute to transition deliverable with guidance.
●Ensure to increase quality in process/workflow and Low Risk/Non-compliance throughout the engagement.
●Handle/Help resolve escalations at the process level to ensure high customer satisfaction.
●Claims Analysis - Analysis claims data/workflow manipulate to improve process efficiency.
●Customer Interaction – Daily /Bi-weekly call, C-sat score, Daily chat/E-mail.
●Contractual Management – Demonstrate a broad knowledge of contractual SLA’s.
●Participate in the ideation process, PPM, Quality, and participate in DRR, BCP, ISMS, Data privacy - PHI, HIPAA.
●Deploy Audit plans and process improvement ideas, Tech support for all line of business.
Infosys BPM, Bangalore - Senior Process Executive
January 2017 - March 2018 Healthcare Payers/Health Insurance – Claims Adjudication.
●SLA Complains and SLA Targets, Individual quality score.
●C-sat, Support TL in engagement activities.
●Claim Adjudication - Process to validate submitted Medicare, HMO, PPO, Medicare Advantage claims to process to pay
●Provider Data - Valid/Verify provider information NPI, TAX ID, provider Location submitted in the claims to process to Pay or deny the claims.
●Claims Adjustment - Provider submitted Medicare claims Adjustment.
●Knowledge Management – Share process/domain knowledge with the team.
●Resolve query in the process/domain.
●Driving Bi-weekly Tech Call, Conduct update session.
●Delivers on the new process /approach in order to meet client and internal goal
Infosys BPM, Bangalore - Process Executive
May 2015 - Dec 2016 Healthcare Payers /Health Insurance – Claims Adjudication.
●Executes transactions as per prescribed guidelines and timeliness.
●Medicare, Commerical claims processing, and Provider NPI to validate provider information process to pay or deny the claim.
●Follows all predefined procedures with the objective to meet the SLA target.
●Ensure that the performance parameter is met and exceeded within the guidelines, policies.
EDUCATION
VLB Janakiammal College of Arts and Science(Bharathiar University), Coimbatore, Tamilnadu- BSc (Computer Science)
Completed - April 2015
Sri.P.Mallaiyan Matric Higher secondary school, Coimbatore, Tamilnadu- HSSLC - Accounts and Computer science.
Completed - May 2012
C.S.I Boys higher secondary School, Coimbatore, Tamilnadu- SSLC - Completed - April 2010
AWARDS
I-Star achieving organization goal in 2016-2017.
Infosys Spot Award for exemplary performance.
Client award and Team recognition award.
Client award 100% Quality and Infosys R&R award.
Infosys Spot award for maintained floor login.
Strenght
●Work well as a Team.
●Ability to work under challenging circumstances.
●Quickly adapt change, Enthusiasm.
●Self-motivated, good negotiation.
●Continuous learner and Can-do multi-tasking.
●Flexible, Patience, Coach People, Motivating people.
●Leadership Confident, Teamwork
●Good written and verbal Communication
Personal Detail
Current CTC - 305,004 PA.
Language known
●Speak, Write, Read - English, Tamil.
●Speak (Proficiency) - Malayalam.
●Speak (Beginner) - Kannada.
DOB - 08/10/1994.
Gender - Male.
Marital Status - Single
Nationality - Indian
Permanent Address:
Door No: 52, Sirram Nagar, Opposite to Aaramba Sugathara Nilayam
Edayarpalayam, Kuniamuthur, Coimbatore - 641008
Declaration
I hereby assure you that the above-furnished details are true to the best of my knowledge.
Place: Yours Truly,
Date: Thinakar S
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