shiju kasimkutty

* I have two years’ experience in Infosys BPO Ltd (in Bangalore, Karnataka, India) from 01 February 2008 to 11 February 2010 as a Senior Process Executive. * I was associated with Honeywell-HAL project in Infosys. Honeywell is manufacturing an engine with the help of Infosys and HAL. For the manufacturing of engine, the parts are manufactured in small industries. * My Roles and Responsibilities were: * Maintaining the records of vendor * Process Capability Study to select the vendor. * Finalize the SLA. * Track and trace process * Quality Review. * Action Plans in case of a batch rejection * Ensure the Conformance Compliance

* From 01 March 2015 to 22 October 2015 I was working in Healthcare Project. My responsibilities were * Review the emails received from Providers and take action accordingly * Decoding medical terminologies * Processing the claims as per the patients Benefits included in the Insurance plan * Verifying whether the providers are In Network or out of Network as per the Insurance policy and applying the benefits. * Pricing the billing manually when the system cannot bill automatically using different tools * Dealing with Enrollments. This includes verifying the enrollment of patients, adding their details etc. * Cross verifying the Insurance policies and the patient’s report summary. * Segregating Medicare and Medicaid claims, then routing the claims accordingly to deal with the process * Checking High dollar claims and verifying whether they have the authorization provided by the Insurance companies. * Handling payment related queries * Claim adjudicating and billing * Creating Reports related to the queries * Tracking login hours information of the team