(555) 432-1000,
Montgomery Street, San Francisco, CA 94105

Diligent, forward-thinking professional with 16+ years of experience, including 10+ years of experience in Healthcare insurance industry. Versatile leader with Six sigma certification who thrives in dynamic, challenging and fast-paced professional environments.  Adept at  coordinating and managing multiple projects simultaneously. Currently pursuing PMP.

  • Multi-unit operations management
  • Project Management
  • Process transition & Stabilization
  • Six Sigma Black Belt Certification
  • Sound knowledge in Medicare, Medicaid, Commercial healthcare plans
  • Problem solving & Analytical skills
  • Team building & Client relationships
  • Good in EDI code set & Optum 837 P/I Compliance check
  • User Acceptance testing
  • Ms Excel, Powerpoint, Word, Visio, Outlook
  • Claims Management & Provider Data management
Academics & Certifications
Sikkim Manipal University , Expected in 2008 MBA : Informational Technology - GPA :
University of Madras , Expected in 2001 Master of Science : Biochemistry - GPA :
, Expected in 2012 Certificate : Six Sigma Black Belt - GPA :
, Expected in 2008 Certificate : Black Box Testing - GPA :
Professional Accomplishments

• Successfully completed assessment and transition of five complex processes within the defined timeline. Managed Service deliverable, Resource planning & hiring, Resource utilization & IT functionality
• Efficiently led User acceptance testing, transition of Quality audit platform & improve auto-adjudication projects for Facets Transformation.
• Efficiently initiated, master-minded and implemented automation of Non-Participating provider creation, Rejection letter creation, auto-capturing of Coordination of Benefits during data entry.
• Led various Organizational Six Sigma initiatives to improve Customer focused cost reduction project, improve profit margin & improve consistent delivery at par SLA for the account.
• Efficiently gathered requirements, executed, monitored and implemented transformation of Data entry to in-house OCR process.
• Consistently maintained account profit margin above 40%-45% focusing on Resource utilization, Identifying and removal of waste processes and accelerating productivity through Robotic automation.
• On-the-demand trainer for several batches for cross-training and new-bies on Claims adjudication
• Consistently generated 85 % average scoring classes of Undergraduates and Post-graduates on complex subjects in the field of Bio-Chemistry

Cognizant Technology Solutions - Deputy General Manager
Eden Prairie, MN, 01/2013 - Current
  • Manage team of claims processors for a Healthcare Payor Operations for processes like Data Entry, Provider Data Management & Configuration. Responsible for hiring, firing and performance management of the team.
  • Act as internal department liaison to assist in transition action items (Service
    deliverable, Resource hiring, Resource utilization & IT functionality)
  • Identify and carry out necessary initiatives to meet account deliverable, improve customer experience and retain staff
  • Accountable for overall Account Performance
Vodafone - Claims Operations Manager
Bangalore, IN, 09/2010 - 12/2012
  • Stellar role in delivering substantial revenue, improving productivity, and generating quality improvements through well-managed and on-time projects and support.
  • Maintained the quality control/satisfaction records, constantly seeking new ways to improve customer service.
  • Effective utilization of techniques like DMAIC, Stratification, SIPOC, Fish bone, FMEA & Cost-Effect matrix for successful completion of project
Rice University - Deputy Manager
Houston, TX, 05/2006 - 08/2010
  • Identified the potential areas of improvements in various projects and establishing procedures, technological innovations, validations and automation thereby positively impacting on their cost, manpower and/or quality. 
  • Ensured process adherence through system edits and automation including software testing on regular intervals to reduce variances and control the process.
SRM Arts And Science College - Lecturer
City, STATE, 10/2001 - 04/2006
  • Nationally eligible Professor accredited through ASRB (Agricultural Scientists
    Recruitment Board, India) evaluation in Biochemistry for Post Graduate students

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School Attended

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  • University of Madras

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  • Claims Operations Manager
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  • Lecturer


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