sr. team leader with 11 years of expertise in operation & team management of bpo
TRANSCRIPT
PRASHANT KISANRAO JADHAVMobile: 09975002491
E-Mail: [email protected] ; [email protected]
OBJECTIVE
Looking forward to an organization which offers a challenging carrier and simultaneously learning environment to work, which provides scope for individual development as well as organizational growth that offers attractive prospective for long term personal development and carrier growth.
CAREER CONSPECTUS
Offering over 10+ years’ experience in BPO industry in Operation Management & Team Management
Strong background in medical Billing process with knowledge in HIPPA compliance Excellent knowledge in Medical billing Concepts – PT Demographics, Charge Entry , payment
Posting , Denials & Patient Statement. A strategic planner with proficiency in streamlining business processes, defining continuous
improvement processes, accelerating employees’ strengths and building powerful teams that can conquer any obstacles.
Currently Working As “Sr. Team Leader” In NDS INFOSERV Pvt. Ltd. (B.P.O.), Mumbai. Successfully Completed Information Technology Infrastructure Library (ITIL V3) Foundation
Training in IT Service Management, 2012. Wide experiences in developing various excel Sheets and pivot tables. Also Proficiency in Excel
add-ins, Build Scripts, building macros, mail merges and Install Shield. Deftness in setting out quality standards for various operational areas; implementing quality
systems & procedures to facilitate a high-quality customer experience, while adhering to the SLA.
Exceptional communication, presentations & mentoring skills with distinguished abilities in leading teams for developing business continuity plans, procedures and service standards for business excellence.
CAREER CONTOUR
US HealthCare / RCM /MEDICAL BILLING / Sr. Team Leader / Dec’2005 - Present; NDS INFOSERV Pvt. Ltd., ANDHERI (WEST).
Accountabilities:
Define project scope, goals and deliverables that support business goals in collaboration with senior management and stakeholders.
Monitor and manage resources (staff, suppliers, and hardware & software) in a cost effective manner, identify opportunities for cost reduction, and action cost reduction initiatives.
Insuring the timely billing of claims, Verifying eligibility and benefits, correction of the denials from the clearing house, timely posting of payments and also insuring all denials from insurance are resolved properly before TAT.
Provide full training to new joiner / team on healthcare domain, medical billing concept, HIPPA, CPT, Federal/Commercial insurance, WC, Auto insurance, HCFA 1500, UB04, UB92, Clearing House etc.
Analyzing denial claims, unpaid claims, correspondence, patient call, transmission, log EDI and availability rejection, eligibility validation and authorization
Handling entire billing process: End To End process for both physicians billing (HCFA 1500) and facility (Hospital) billing (UB92).
Track the SLA violation and ascertain continuous improvement in service delivery.
Effectively communicate project expectations to team members and stakeholders in a timely and clear fashion.
Liaise with project stakeholders on an ongoing basis. Security awareness and training program for all members of the workforce, including
management. Draft and submit budget proposals, and recommend subsequent budget changes where
necessary. Ensures all project commitments are met, and monitors and reports on progress to Senior
Project Manager, sponsor, and customer, as well as the PMO in accordance with the reporting standards, ensuring the project remains within scope.
Develop and implement policies and procedures for responding to an emergency or occurrence (such as fire, vandalism, or natural disaster) that damages equipment or systems
Diagnoses and evaluates potential risks and issues throughout the project. Reports regularly to the PMO and Senior Project Manager with regard to risks, and executes appropriate plans to contain them.
Acts as escalation point for problems and complaints, and manages compliance, contingency, and risk situations within own area of control.
Knowledge of US health insurance – Medicare, Medicaid, Aetna, blue cross, blue shield, CIGNA, United health care.
Compile and prepare consolidated performance reports and MIS reports like Monthly billing productivity and Accuracy Reports to assess the progress of the process.
High comfort level working in a diverse environment.
CORE COMPETENCIES
Process Management Mapping clients’ requirements and coordinating in developing and implementing processes in
line with pre-set the guidelines. Monitoring the overall functioning of processes, identifying improvement areas and
implementing adequate measures to maximize customer satisfaction level. Assessing the customer feedback, evaluating areas of improvements & providing critical
feedback to the associates on improvements and achieving higher customer satisfaction metrics.
Customer Relationship Management Setting out quality standards for various operational areas, ensuring a high-quality customer
experience, while adhering to the SLAs and work processes. Creating awareness for driving the projects and process improvement strategy & methodology,
ensuring maximum operational efficiency. Conducting root-cause analysis and taking preventive measures for repeated escalations.
Quality Assurance Conducting internal process audits & process reviews for ensuring strict adherence to the
process parameters/systems. Accomplishing the set quality standards in SLAs.
Team Management Leading, training and monitoring performance of the team members for maintaining excellence
in the service operations; evaluating effectiveness of training & development programs; formulating or reviewing training Strategy and determining appropriate instructional methodologies and formats.
Creating and fostering a healthy environment which facilitates high performance of team members and accomplishments of organizational goals.
SCHOLASTICS
B.E in Information Technology from Pune University in 2004 Diploma in Computer Technology from Mumbai University in March 2001. Successfully Completed Certification of Microsoft Technologies (.NET) From NIIT (Mumbai).
Certified IT Infrastructure Library (ITIL V3) Foundation Certificate in IT Service Management, 2012
PERSONAL DOSSIER
Date of Birth : 12th November 1981. Marital Status : Married. Languages Known: English, Hindi and Marathi Present Address : G-II, Ashwamedh Apt., Near Girija Nursing Home, Ulhasnagar -4, Mumbai-
421004.