Resume
Name: Maddirala Harini Yadav
Email ID:
Phone: 7799208766, 9346045546
Career Objective
To work with an organization that can best utilize my logical and analytical capabilities and
Offers me a professional growth
Full Timework Experience 7 years 6 months (Oct 27th 2011 Till Present)
Current Employer: ICICI Lombard Health Insurance, Hyderabad
Operational processing executive
Duration: (October 2011 April 2012)
Designation: Customer Service Manager
Job Profile:
1.
Processing claims (Pan India)
2.
Operational process
3.
Checking for medical Admissibility of the claim
4.
Meeting the TAT
Responsibilities:
Coordination with support groups for Allocation & Closure of Interactions
Quality & Training support to Claims processing team
Data collection & data reporting
Daily, weekly &Month-end Dashboard reporting
Engage in improving processes to minimize the TAT
Process:
1.
Corporate Processing claims processing(corporate reimbursement)
2.
Retail policies claims processing based on the policy terms and conditions
Service delivery
1.
Coordinate with the internal members for the claim to be processed to meet the
2.
TAT
Designation: Associate
Duration: (April 2012- July 2013)
Process
1.
CEP new initiative programmer handled and co ordinates
Job Profile
2.
Maintaining TAT reports
3.
Coordinating with Various corporate HR's (Better service provider )
4.
Cases which are not resolved by the corporate with resolution
Responsibilities:
1.
Maintaining of loss ratio Records of the corporate
2.
Co coordinating with the corporate HR of the various corporates which are enrolled
3.
with us for the better service to the stake holders
4.
Giving the reports to the HR based on the requirement on the loss ratios
5.
Team Work Allocation & Productivity management
6.
Providing support to team in resolving issues & queries
7.
Training support to New Joiners
8.
Maintaining & reconciliation of Payment tracker
9.
Claims processing & Data Sanitation
10.
Collation of intimation data & sharing the same with central team
11.
Supervising the activities of Trainees
Process:
1.
Corporate Processing claims processing (corporate reimbursement)
2.
Retail policies claims processing based on the policy terms and conditions
Service delivery
1.
Coordinate with the internal members for the claim to be processed to meet the TAT
Designation: Customer Relationship Manager
Duration: (July 2013-May 2017)
Process:
2.
Operational
3.
Non health(Motor and Personal accident)/Health(corporate and retail)
4.
PA-WC MIS excel 2007
5.
Application: Samadhan
Responsibilities:
1.
Publish weekly & monthly MIS, Tat reports for interactions created, closed and under
2.
process in UCV application customer query resolution tool in ICICI Lombard
3.
Prepare and publish YTD MIS for products WC, SMC, IPA, and JPA &PA as per the
4.
business requirement
5.
Managing internal query from the MO/RM related to health and allied services though
6.
SAMADHAN application in ICICI Lombard
7.
Worked on the mails addressed by external customers to the business mail id
8.
9.
Worked for CRM (customer relationship management) on various operational process
10.
to meet the TAT
11.
Follow-up for the proactive approval and denial of discretionary activities vacations,
12.
trainings, meetings.
13.
Attend weekly and daily staffing review meetings with management and
14.
Forecast/scheduling analysts detailing previous and current week's performance
15.
and forecasted performance of remainder of current week and next week, while also identifying
16.
risks
17.
Fill overtime and under time availability.
18.
Co-coordinating with the IT team for developing new tracking tools in improve
19.
forecasts.
20.
Documenting all MIS reports.
Perform other duties and assignments as directed.
1.
Coordinating with OPD doctors for Monthly Invoices & Query Resolution
2.
Coordination with central team for OPD payments and reconciliation
3.
Training support to New OPD doctors for using RPOS (Rural Point of Service) Software
4.
and explaining cashless Hospitalization process
5.
Periodic Hospital Audit to verify the claims authenticity & Data Sanity Process
6.
Generating MIS & Reports and submitting to my superiors
Process
1.
Working in payments reserving team.
2.
Handling MIS of claims under the applications worked.
3.
Analyzing the interactions pending and worked data from excel.
4.
Coordinating with regional managers and claims team.
5.
Publishing reports closed, pending and rejection cases. Coordinating with ICLM(internal control
and loss minimization) for fraud score claims.
6.
Monitoring the Quality check on cases closed and pending every 15 days basis.
7.
Corporate Processing claims processing(corporate reimbursement
8.
Retail policies claims processing based on the policy terms and conditions
Service delivery
1.
Coordinate with the internal members for the claim to be processed to meet the
2.
TAT
Competencies
1.
Excellent Oral and written communication skills supported by a strong sense of team
2.
work
3.
Flourish in independent, collaborative and work pressure environment
4.
Self-motivated & quick learner
5.
Green Belt Certification (without project) from RABQSA
6.
Computer Proficiency : MS office
Essential Management Skills: Successful completion of 4-day management workshop
Designation: Associate
Duration: (July 2017- Till date)
Process:
1.
Operational
2.
Non health(health check up)
3.
MIS data management
4.
Application: I3
Responsibilities:
1.
Publish weekly & monthly MIS, Tat reports for interactions created, closed and under
2.
process in I3 application Discrete data analysis tool ICICI Lombard
3.
Prepare and publish YTDMIS for products RBI Annual health check up for HRA PURPOSE
4.
Managing internal query from the MO/RM related to health and allied services though
5.
HEALTH CHECK UP portal application in ICICI Lombard
6.
Worked on the mails addressed by external customers to the business mail id
7.
8.
Worked for CRM (customer relationship management) on various operational process
9.
to meet the TAT for the various DC's pan India co ordinate with the payment team for
10.
clearing of the invoice payment to the dc
11.
co coordinating with PMT (provider management )for the dc service
12.
Follow-up for the proactive approval and denial of discretionary activities vacations,
13.
Trainings, meetings.
14.
Attend weekly and daily staffing review meetings with management and
Perform other duties and assignments as directed.
1.
Coordinating with OPD doctors for Monthly Invoices & Query Resolution
2.
Coordination with central team for DC payments and reconciliation tracker to the pmt
3.
providers of the region
4.
co coordinating with the vendor for the system advancements for automatic discrete
5.
data of huge volumes by an application I3
Service delivery
1.
Coordinate with the internal members for the claim to be processed to meet the
2.
TAT
3.
proper functioning of the application with advancements required handling the
4.
team to meet the targets
ADDITIONAL ACITIVITES:
1.
Working with AGGREVATOR also SLA And RCA(root cause analysis) reporting for the senior
management regarding the glitches in the process
2.
HANDLING a team size of(15-20 )no's (1 and ½ years )
3.
Maintain tat reports and the productivity consolidations of the same
4.
Dashboards and tat publishing data fortnightly (pivot, dashboards ,vlookup_and other functional
activates of excel)
5.
Assigning the tasks and ensure the closure of the same in the prescribed time line (9 hrs Tat0
Academic Profile
1.
Masters Pharmacy (pharmaceutics) (2011-2013)- Percentage (JNTU) 86%
2.
Bachelor of Pharmacy Percentage(2007-2011) (JNTU) 78%
3.
Board of Intermediate (BiPC) (2005-2007)- 90%
4.
Board of secondary education (SSC) (2005)-81%
Personal Details
Date of Birth 7th March 1990
Languages known English, Hindi & Telugu.
Marital Status Married
Permanent Address W/o G . Vishal Kumar Flat no: G2, sandy spring, Tulip block,
Sy no -9/E, Manikonda, Near sundar
Function Hall, R.R -500089