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B-27 , PANDAV NAGAR COMPLEX GANESH NAGAR, NEW DELHI, DELHI-110092, INDIA
Cont - 91-9810403855
EDUCATION B.Sc (Hones) Bio-Technology (2006-2009) MIMT, CCU university, Greater Noida, UP, India Course Relevant to major: ■ Core Bio-Technology ■ Clinical Research ■ Clinical data management ■ MS-Excel, Power-point, Word ■ Allied Healthcare
■ Bio-informatics ■ Healthcare informatics ■ Detail Computer application ■ Medical Coding ■ Medical Informatics
CERTIFICATION ■ Several Online Certification on Clinical Trial & Research Management, Clinical Investigation Regulatory Process from FDA/NCI/NIH/CMS. ■ Green Belt (Train and Tested). ■ Lean Certified. ■ Several soft skill certifications. ■ Many Technical skills certified. DOMAIN EXPERTIES ■ Healthcare data management ■ P&C Policy Services. ■ US Worker’s compensation knowledge. ■ US Health care database development & Management.-Developing Medical Fee Schedule for Providers & Payers for Ingenix. ■ Adequate knowledge of CMS (Center of Medicare & Medicaid) policies & rules. ■ Clinical Research and Trial data management. ■ Medical coding. ACCOMPLISHMENT ■ Recognized for Process Re-engineering with Lean and Six-Sigma Implementation. ■ Won Silver Award for ‘Best Lean Idea and Six Sigma Implementation’. ■ Designing Process Workflow tool as Green Belt Project. ■ Green Belt (Train and Tested). ■ Lean ‘CAP’ Certified. ■ Single Point of contact for Happiness and Fun in the department. ■ Represent Genpact Volunteer for Teach India Volunteer program. ■ Developed several concept to accelerate employee satisfaction and team work. ■ Work with Sr. Knowledge manager to get some new Clinical Trial Project.
LEGAL EXPERIENCE EXPERIENCE-1 GENPACT : FEB 2007- PRESENT. ■ Transition and stabilization of a SFS (State fee schedule) from Salt Lake city, Utah, US, Ingenix, to Genpact. *SFS-Ingenix is the exclusive publisher of the official Workers Compensation Fee Schedule for several
states. As a P&C specialist I need to refer this information to determine correct reimbursements. Specific data varies state by state, these comprehensive references generally include state-specific rules and guidelines, fees or relative value units, CPT® codes, and applicable state-specific codes for services rendered. **SFS Database-The Ingenix State Fee Schedule Plus Module is a database of timely and consistent fee schedule data arrayed to serve organizations that adjudicate or review workers’ compensation and auto medical bills. This module helps payers and providers to obtain timely and consistent state medical fee schedule data and Advance optimal bill review efficiently. ***SFS and Powertrak-Data is stand alone payable application and the main feeder of Powertrak (covering the 25% market share of USA Medical bill review application)
■ KEY RESPONSIBILITIES CLIENT INTERACTION ■ Interact with client coordinators for process related issues. ■ Maintain and report MIS of activity (output) for individual team member. ■ Serve as process ambassador and represent team during client facility visits. ■ Conduct Conference calls with the overseas client. ■ Be in regular email contact and ensure all problems are ironed out on a timely basis. ■ Resolving escalated queries through online CRM portal (Onyx and Dev-track). TEAM RESPONSIBILITIES■ Actively manage staff on a regular basis to ensure all issues are dealt with effectively and efficiently. ■ Conduct weekly meetings, Monthly KAT (knowledge assessment test) with the team member. ■ Resolve escalated Client queries. ■ Support and assist the Sr. Manager Operations. QUALITY CONTROL■ Implement service standard parameters for all business processes and customer touch points. ■ Measure and monitor against benchmarks, to ensure all quality standards are adhered to; data collation, mining, measurement and reporting. ■ Implement and follow a quality audit process for the assigned functions to identify and track errors, process gaps; establish feedback mechanism to capture voice of customer. ■ Recommend and implement change for procedure, systems, and training. ■ Assist in coordinating, conducting training programs for implementing and improving service standards.
EXPERIENCE-2 I-ENERGIZER: Dec-2006 to Feb-2007 ■ Solely responsible for getting Inpatient Medical Coding Project.
EXPERIENCE-3 PACIFIC INDIA VENTURE Ltd.: Nov-2003 to Dec-2006 ■ Responsible for Medical coding and Auditing Surgery outpatient/ inpatient /ER//, CPT, ICD-9/10 CM, APC, DRG coding. ■ Denial Management Audits. ■ Providing training for Medical Terminology, Anatomy and Surgery. EXPERIENCE-4 RANBAXY : Aug-2002 to Feb-2003 ■ 6 Month of Educational Internship Experience in Clinical Research Process and clinical data management. ACTIVITIES/SKILL COMPUTER SKILL: ■ MS-Window, MS-Excel (advanced), MS-Pwerpoint (advanced), MS-Word. ■ Statistical software – SPSS, Minitab. ■ Healthcare Software – Medical Manager, Powertrak, Encoder-pro, Code Manager. ■ Online CRM tool – Onyx, Dev-Trak COMMUNICATION SKILL ■ Team Management, Team Leadership, Organizational behavior, Time management, Change management, Presentation skill certified. ■ Proficient command over English and Hindi. ACTIVITY & HOBBY ■ Tarot Reading, Bike Riding, Philosophical reading, Cooking , Photography. PERSONAL DEMOGRAPHICS ■ Date of Birth 15th September 1986 ■ Nationality Indian ■ Sex Male ■ Marital Status Never Married ■ Mailing Address: Residential: B-27, Pandav Nagar complex Ganesh Nagar, New Delhi-110092, India. Official: Genpact, Building No- 4, DLF Phase-II, Cyber city, Gurgaon, Haryana-122002, India ■ Contact No- 91-9810403855 ■ E-mail – email@example.com firstname.lastname@example.org
Date: SEP/05/2008 Place: New Delhi INDIA
Reference-1 Karine McOmie Manager, P&C Regulatory and Development Ingenix, Inc. 2525 Lake Park Blvd. West Valley City, UT 84120 801-982-3362 Cell, 801-631-1044 Karine.McOmie@Ingenix.com Reference-2 Sue Carlson P&C Regulatory Specialist Ingenix * 5833 SW 27th Terrace * Topeka, KS 66614 Tel 785-271-6563 * Fax 785-272-4963 email email@example.com * Internet www.ingenix.com Reference-3 Raman Sawhney Contact No- 91-9916989452 E-mail – firstname.lastname@example.org