An established healthcare IT Professional with 11 years of US HealthCare experience in areas of Process/People Management, Benefit Configuration, Business Analytics, Quality Assurance, Claim Administration, Benefit/Plan Loading and Process Training. A B.Sc. graduate by qualification with proven track record as a Healthcare Consultant with reputed companies. My career aspiration is always aligned with organizational goals to deliver customer oriented solutions. Highly disciplined and self-motivated professional who brings a positive and result oriented approach to all tasks undertaken, and have the ability to work well, both in a team as well as in a sole environment. I am specially recognized for decisive leadership and proven ability to face challenges. Profile Summary Leadership by example. Functional Lead with people management skills. US Healthcare Professional with career spanning over 11 years distinguished by commended performance. Strong Knowledge on payer domain areas. Well versed in commercial Fully Insured & ASO Line of Business. Claims Administration, Appeals/Adjustments, HIPAA, ICD -10 and EDI 270/271 Transactions knowledge. Case Installation, Plan Setup and Benefit Configuration Specialist for Fully Insured & ASO customers. Work Experience on healthcare tools like Facets 5.01, Mainframe (Rumba & TOPS), ACIS, ECHS. Excellent interpersonal, presentation and analytical skills, aptitude and ability to adapt the new concepts. Quality Assurance, Business Analytics & Process Training are added skills. Strong Data Model, SQL Query & Claims Data Mapping Knowledge.
