Team Members Process Specialist

S. Manivannan

Contact # 892-***-****

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

Career Summary:

* ***** *** ** ** experience in US healthcare process, in payer and provider side. 4 years experience in team management and quality control. Strong knowledge in RCM, Denial management, Claims, Provider database management.

Strengths:

Self-confident, Hardworking, Good communication skills, Team Management, Quick learner & Capable of handling higher responsibilities & work pressure independently. Always willing to learn new technologies.

Working Experience:

Organization : Cognizant Technology solutions.

Designation : Process specialist- Data

Period of employment : From May 2019 to May 2023 (4 years) Process brief : Maintaining the providers data behalf of Cigna. As per the requested mail or fax we need to check and confirm whether request received for provider Add, update or term. Based on the request we have to update in our tool. Organization : NTT DATA Services

Designation : HC & Insurance Ops Sr. Associate

Period of employment : From May 2015 – March 2019 (3 years and 10 months) Process brief : Review of EXPLANATION OF BENEFITS, hard copy or soft copy or remits given by the insurance company which discuss in brief about the types of service covered and payment details of claims based on this document we need to capture appropriate actions like Patient billing, adjustment or write off and denial or appeal process. Applications Familiar:

• CPF/Provider work bench – Update provider HMO product.

• Activity manager – Add provider demo details and update OAP, PPO products.

• GSI/GMI site – To check instruction based on group and state level.

• Cred viewer – Validating provider status.

• IBM Mainframe software – Pterm.

• Web Image Software - To view EOB / Correspondence

• Bank Remittance in Web – To view EOB

• Medicare and Medicaid Portals – US Federal Govt Sites

• Microsoft SharePoint site – To view client Documents Present Role:

• Handling the team – Assign work among the team members and effective use of the resource.

• Achieve 100% production, Maintaining the TAT, Quality and Attendance of the Team.

• Analyze the team new members processed account on daily bases (QC).

• Share the audited details to team members and Managers.

• Providing Feedback to the associates on a daily basis.

• Seeks methods to continually enhance the business process, quality and improve efficiency.

• Ensuring feedbacks and issues from team members are dealt appropriately and escalate priority issues to management.

• Attending client call on weekly bases and communicate the client instruction to the team members in team huddle.

Achievements:

• Promoted as process specialist in a short period in Cognizant

• Promoted as quality analyst in NTT Data.

• Travelled to Coimbatore for team improvement.

• Awarded Best performer in 2017.

• Got best employee award three times in Cognizant. Academic Qualification:

2014 B.sc Computer science from DRBCC Hindu College Passed out with First Class in 2014

2011 Passed out Higher sec from Govt Higher sec school, Kolappancheri with First Class in 2011 Personal Profile:

Fathers Name : K.Sundarraj.

Date of Birth : 27-06-1994

Permanent Address : No:397,Sorancheri Main road,Kuppathemedu, Poonamallee, Pattabiram(Post) Chennai-72

Sex : Male

Hobbies : Cycling, boxing, listening music

Marital Status : Single

Nationality : Indian

Linguistic Proficiency : Tamil, English

Declaration

I hereby declare the above given information is true to the best of my knowledge and belief. Place: Chennai S. Manivannan

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