Durga Prasad Vattikunta

Process Associate @ Optum

About

I am a results-driven Healthcare Operations professional with a specialized focus on Enrollment Eligibility and US Claims Processing. Currently at Optum Global Solutions, I manage complex member eligibility for Medical and Pharmacy benefits while maintaining a consistent 100% accuracy rate. My expertise lies in navigating the Facets platform (Unison/RV 4.71) and Citrix environments to ensure seamless data integrity. I have a proven track record of handling high-volume workloads, consistently validating and indexing 200-250 members or documents daily while strictly adhering to Turnaround Time (TAT) protocols. Beyond my core operational tasks, I am passionate about leadership and team development. I have served as On-the-Job Training (OJT) support for new hire teams and lead team update meetings to ensure project goals are met. My experience includes working closely with Onshore teams to resolve complex process queries and updating critical member information, such as Primary Care Physician (PCP) details. Core Competencies:Systems: Facets (Unison & RV 4.71, CSP), Citrix, MS Office. Domain: US Healthcare (Medical & Pharmacy Benefits), C-SNP Enrollment. Soft Skills: Team Leadership (OJT), Data Analysis, and Solution-Oriented Problem Solving. I am always looking to connect with professionals in the Healthcare and Operations space. Feel free to reach out!

Country

India

City

Vijayawada

Industry

Computer Software

Skill

Intermediates, Onsite-Offshore co-ordination, Process Validation, Demography, Healthcare Compliance, Microsoft Office, Time Management, Service-Level Agreements (SLA), Primary Care Physicians, Functional Requirements, New Hire Training, Enrolled Actuary, Communication, Unemployment Claims, Healthcare, Claims Processing, Employment Verifications, High Level Of Accuracy, Team Coordination, Data Entry

Experience

Process Associate

Optum

2025-5 - Present · 1 yr 5 mos

Hyderabad

Working knowledge on Platform/ Applications: • Citrix, Facets (Unison Facets 4.71, RV Facets 4.71, CSP) Roles and Responsibilities: • Checking member eligibility for medical and Pharmacy benefits. • Fixing the member Demographic Errors. • Daily tasks will require to input, review, research, verify, update, or correct member information. • Maintaining instructed TAT on timely manner. • 100% accurate in processing claims for various states in United States. • Validation/ Indexing of minimum 250-300 documents per day. • Understanding Issues & Problems of project and Tasks initiative to Resolve. Experience - 2 • Chronic Condition Special Needs Plans (C-SNPs) are that restrict enrolment to special needs individuals with specific severe or disabling chronic conditions like Diabetes, Chronic Heart Failure and Cardiovascular Disease. Member should have at least one chronic disease to enroll in this plan.