日本と海外をつなぐクラウドソーシング

Amvik Solutions

Client Relationship Manager

2016/06～ 2018/04

Roles & Responsibilities

• Associated with US Healthcare Division.
• Individually held responsible for 5 practices based on insurance billing both government & commercial, EOB management, Collections for aging AR, Eligibility & Benefits verification & obtaining Authorization (ABA Therapy – Behavioral/Mental Health).
• Responsible for the provider payments from insurance on time without any delay.
• Close follow up of clients through e-mail (regularly) and calls (bi-weekly).
• Patient responsibility invoicing and follow up.
• Comprehensive reporting – account ledger & claims denial report including an action trail documenting follow up correspondence with insurance companies and funding sources.
• Achieving 100 % Operational metrics in all 5 practices especially in revenue generating part.

Intelenet Global Service (Serco)

Team Leader

2015/03～ 2016/03

Intelenet, a global firm does it’s 24/7 services for contact center, transaction processing, finance & accounting and human resource outsourcing services to Fortune 500 companies in the UK, US, Australia and India. Intelenet has 31000 employees across 30 delivery centers globally in India, Philippines, Mauritius and US. Currently the company is featuring in its healthcare program with multiple clients and one of the major clients in US “APRIA” is tied up with Intelenet for its dedicated and quality service.

Roles & Responsibilities

• Associated with US Healthcare Division.
• Managing a team of 30 live wire team members with Daily Reporting for member DME process.
• Conducting daily team huddles and motivation sessions to enhance performance.
• Daily tracking of the Quality Dashboard for Team to check of any Quality error.
• Updating Production Dashboard and the Monthly procurement Dashboard on a daily basis.
• Close follow up of clients through e-mail and calls.
• Achieving 100 % Operational metrics in Production and Quality on the floor consistently.
• Responsible for entire team’s performance and to drive the team with positive attitude as well as to fly-high by meeting up the SLA’s.

Accenture

Subject Matter Expert (SME)

2013/09～ 2015/01

Accenture, a Global Fortune 500 conglomerate is a Management Consulting, Technology Services and Outsourcing Company helping clients in India become high-performance businesses and governments in the areas of Strategy, Digital, Technology and Operations.

Roles & Responsibilities

• Associated with PNC's Mortgage Services & US Healthcare Division
• Managing a team of 32 live wire team members with Daily Reporting for member enrollment process
• Conducting daily team huddles and motivation sessions to enhance performance.
• Daily tracking of the Quality Dashboard for Team to check of any Quality error.
• Updating Production Dashboard and the Monthly procurement Dashboard on a daily basis.
• To Audit the documents within the turn around time as per the Investor’s requirements
• To “Fail” the incorrect and illegible documents and re - route it for the correction queue
• Close follow up of clients though e-mail and calls
• Achieving 100 % Operational metrics in Production and Quality on the floor consistently
• To check and procure Correction documents if any documents with error is procured earlier

Cognizant Technology Solutions

Senior Process Expert (SPE)

2011/06～ 2013/08

Cognizant, with HQ in NJ, United States combines a passion for client satisfaction, technology innovation, deep industry and business process expertise and a global, collaborative workforce that embodies the future of work. It is ranked among the top performing and fastest growing companies in the World.

Roles & Responsibilities

• Senior Process Expert (SPE) in Health Care
• MEDdata Billing process with Professional Billing terminology
• Review and posting Claim status into Cash postings, Refunds, Denial Management & Charity Write - off.
• Handled WellPoint and Proverge HCP (Health Care Professionals)
• Managed Credentialing process with Anthem Blue Cross & Blue Shield.
• Verification of providers Education and Board Certification at various levels
• Malpractice and Background verification process
• Checking State license validity and verification of breaks if any in career path

Perot Systems – Dell Services

Senior Accounts Receivable (AR) & Quality Assurance (QA

2007/06～ 2011/06

Perot Systems was an Information Technology services provider founded in 1988, based in Plano, Texas, United States. As a Fortune 1000 corporation with offices in over 25 countries, Perot Systems was acquired by Dell in 2009.

Roles & Responsibilities

• Senior AR for Claims and Denial Management
• Analyzing Explanation of benefits (EOB) forms and posting payments
• Capturing denials and indexing rejection page
• Group payment postings and balance refund to patient and insurance firms
• Posting Interest & Indigent payment
• Handling a 7+ member team
• Additional responsibility of Audit checking payments already posted
• Analyzing reason for credits
• Creating the Insurance, Promotion and Deactivation

AlTechStar BPO

Customer Service Representative (CSR)

2005/05～ 2007/05

AltechStar - BPO division is a Global service providing company backed by Billion Dollar ETA Ascon Group, Dubai with focus towards IT Enabled services. AltechStar - BPO division is operating in India, United States, Sri Lanka, United Kingdom, Bangladesh and Ethiopia.

Roles & Responsibilities

• Outbound Call Center experience for United States and United Kingdom Outbound Campaigns
• Performing competitor analysis and offering the customer the best package
• Lead generation, Cross selling and Up selling of utility products for a British majors
• Managed targeted campaigns for high value customers
• Promoted as Senior CSR within 7 months for achieving Sales Metrics in Business to Customer calls
• Product and Service includes home phone connections and Mobile phone connections for AT & T, Sprint, Verizon and T Mobile.
• Convincing customers during sales pitch on US and UK timings to upgrade to new brands and models
• Achieved highest sales for 4 consecutive months and appreciated by Management and overseas Client.
• Postpaid and Prepaid phones with Direct to Home (DTH) television packages
• Meeting daily targets and won accolades for kudos call on the floor
• Awarded “Best Group Leader for the Quarter” and “Spirit of Sales Team”