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@intouchleo
Flag of India Pathankot, India
Member since 22 Kasım 2009
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intouchleo

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UnitedHealth Group is an innovative leader in the health and well-being industry, serving over 70 million people across the globe. Ranked #21 in the Fortune 500 list of America's largest corporations and headquartered in Minnetonka, Minnesota, USA, employing over 55,000 people worldwide. Company Name : UnitedHealth Group Designation : Subject Matter Expert Department : Healthcare (UBH facets) Duration : 16th July ’07 to till date Skills used : Knowledge of US Healthcare & Insurance • Provided helping hand to MT and new AM in understanding all work types, their CPH and Inventory distribution. • Acting SME for more than three months. • Regular quality Audits for the entire team. • Providing floor support and query resolutions. • Working as dedicated processor for PG and dedicated groups. • Audits for dedicated and PG groups. • Done Maximum Overtime and stretch as per business requirement. • Collating and distributing work to whole team. • Maintains daily status report on daily basis. • Updating TAT report on monthly basis as per the data.
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Deneyim

Business Anaylst

Sep 2013

I am in a part of UAT (User Acceptance Testing) team, I am aligned to multiple projects. 1. Facets - BIC: Here I validate healthcare benefits on facets, Creating high level scenarios and Testing (executing) test case as per the Scenarios. 2. Linx (Puma): Executing Test scripts on PUMA application 3. Facets - HPHC, Duncan: Creating claims for Test Scenarios for EOB, ECK, PRAand PRC

Configuration Analyst

Oct 2012 - Sep 2013 (11 months)

Department/Process: Configuration Services/Business Rules Configuration (BRC) Role and Responsibility: The job mainly deals with the configuration of Benefit & pricing along with Unit Testing for Medicare, Medicaid and Commercial Plans. This includes client interaction. Worked on below applications of FACETS: Claim Processing: Medical Claim Processing Hospital Claim Processing Medical Plan: Product, Service payment, Service/Procedure Conversion, Service/Revenue Conversion, Supplemental/Procedure conversion, Supplemental/Revenue Conversion, Service Rule Definition, Deductible Rule and Limit Rule. NetworX: NetworX Qualifier groups, ASC maintenance, APC maintenance, Medical agreement Configurator, Source Maintenance, RBRVS Maintenance. Workflow configuration: Routing rules, Qualifier group, Routing reasons Also Worked on Providers, User warning message. Worked on both Frontend and Backend on Facets 4.71. Application Used: Facets 4.71 and SQL.

Subject Matter Expert

Jul 2007 - Oct 2012 (5 years)

Department/Process: Claims processing/Healthcare, UBH facets (P3) Skills used: Knowledge of US Healthcare & Insurance Role: • Data entry, Processing and Auditing high dollar Physician and Inpatient claims • Working on fresh, adjustments and Escalation (appeals) claims • Preparing reports on Exccell

Associate

Dec 2006 - Jul 2007 (7 months)

Processing Claims for US healthcare: Medical, Pharmacy, Vision, Dental, Hospital as per the mambers benefit.

Eğitim

BCA

2003 - 2006 (3 years)

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