* Regional Head of Cashless and Reimbursement Claims operations along with client services for entire Tamilnadu, Pondicherry, Karnataka and Kerala region. * Handle team of 230 members towards end to end claims processing ensuring maintenance of Outstanding claims and adjudication of claims within the TAT as per SLA. * Review of medical query and deficiencies * Recommission for denial/rejection * Investigation management (both medical & non-medical) * Periodical review of all the claims pertaining to brokers and insurers and submit the report for review of performance. * Provide day to day medico technical support related escalations by the team of doctors and conduct random audit to ensure process compliance. * Assist with mandatory insurer audit and ensure compliance of regulatory norms. * Maintain healthy relationship with insurer and brokers for retention and new business prospects. * Manage the business retention of around 250+ Crs premium of both retail and corporate business and comply with 100% retention balancing revenue targets accordingly.

• Providing error free adjudication and maintenance of TAT of pre-approval, member reimbursement and claims repudiation.• Involved in part of Claims Automation structure where in all the efforts made to improve customer experience in reduced TAT adhering to all norms as per the policy conditions.• Responsible for daily operations, planning for future workflow and scheduling as per time and motion study and other administrative activities• Identifies and supports improvement opportunities for the Submission / Re-submission / Reimbursement unit.• To constantly evaluate the efficiency of the team and identify bottlenecks and eliminate as per the requirement• To train, motivate and supervise all personnel within the claims team & upgrading the skills of the existing team.• Maintaining the department statistics in terms of productivity, quality and TAT. MIS Reporting on medico productivity / IRDAI reports• Providing uninterrupted service delivery creating benchmarks exceeding the customer expectation being the key.• Supervising and guiding the Claims team in fulfilling adopted procedure of claims settlements and claim investigations in line with claims philosophy • To periodically review, assess and enhance claim processes and checklists to ensure efficient and error free claim processing • Coordination with internal departments (like presenting feedback to UWD, Service providers) and with external contacts like Investigators, Medical experts * Put up for approval/ repudiation of claim • Assess enhancement needed to the Claims Module based on feedback from team and Coordinate with IT for the same • Guide team to compile and classify ombudsman and consumer forum cases for reference purposes and arrange documents to support legal team on contested claims with Ombudsman / Courts. • Internal Auditor for ISO 9001:2015 health claims audit

• Manage and process Pre-Authorization and Reimbursement medical claims from the corporate hospitals.• Provide assistance and expertise in respect of complex, large-loss and contested medical cases from corporate service providers across India.• Proficient to handle complex high value claims, fraudulent and phantom claims, medical negligence and violation of clinical, healthcare and statute governance claims.• Collate denial letter background information and provide validation to rejection team.• Review of hospital tariff against their billing mechanism, apply proportionate charges on various components of the medical bill and prepare optimal utilization reviews to achieve significant control on claims loss ratio. • Review of Pending claims and follows through for payment in a timely manner. • Managing effectively Customer Grievance and Escalation pertaining to claims.• Facilitate claim process integration with network providers and their agreed rates to mitigate the claim ratio by 60%• Generated return revenue on investigating fraudulent claims by the service providers meticulously.• Effectively negotiated on the final bill thereby brought in substantiate huge quantum reduction every month in settlement of claims.• Thorough Due Diligence in Claims Rejection process and brought down the customer grievance escalation.• Exponential increase of the Pan India Networking of Providers to 8500 hospitals and 1500 Diagnostic Centres in short duration by efficient and prudent networking mechanism.• Empanelment of service providers with an agreement on End to End Packages for 700+ Surgical and Medical procedures by determining geographically reasonable and customary costs for treatments, to facilitate healthy business model across the chain.• Manage a team of 48 members across the country and 12 members at Head office reporting directly.• Conduct Health and Wellness programs for customers, sales force, corporate through our providers.

• Provide Ayurveda and Yoga Consultation to the Corporate clients for healthcare wellness programs.• Development and Implementation of growth strategies towards new Pharma products• Formulate new Pharma products, conduct clinical trial for quality assurance. Conduct CME and Sales Force Product Training. • Establish Global footprint for the products and healthcare Ayurveda consultation.• Responsible for providing the sales team with the necessary technical expertise to enable them to sell the product through printed LBL, Visual Aid, etc and electronic promotional materials as news letter, white paper, blogging, etc, product training, and relevant clinical papers.• Responsible for reviewing product data to ensure that the field force is kept up to date on new developments regarding the companies or competitors products.• Develop operational plan to execute through a mix of online and offline models which includes paid search, search engine optimization, display, affiliate networks, social media marketing to drive increase in users on web as well as mobile.• Responsible for implementing digital marketing strategies for market entry & penetration for the existing & new international markets footprint for the company• Manage creative, media buying & search services to deliver on marketing objectives of the company• Develop and execute powerful promotional plans to increase the market share of the company in the various product offerings• Leverage data and perform analysis to deliver strong marketing efficiency and create an advantaged digital marketing effort.• Close liaison with the field force to assess the response to and suitability of current promotional material and to ensure that the printed promotional material is being used optimally.

Indus Valley Ayurvedic Centre is an award winning authentic Ayurveda clinic & Medical spa resort in Mysore, which is the first to be ISO certified in India. • Lead a team of domain experts within the Business Integration and Business Development Team at IVAC.• Lead the Ayurveda Expert team in the new research project development on Efficacy, Safety and Standardization of Ayurvedic Wellness solutions• Key member of the cross-functional team identifying research methodologies to establish the purity and efficacy of authentic Ayurvedic formulations• Lead New Project Development including Technical (Domain) Evaluation of new initiatives – Academic services, Clinical services, Product knowledge training, Ayurveda research, Ayurveda authentic content creation & distribution• Identifying risks and resource gaps in the evaluation of new initiatives• Creation of training programs to develop skills of internal resources • Development of marketing strategies with new packages and offers.• Development of healthcare and personal health training solutions for corporate clients• Development of education and training programs for international students visiting IVAC’s academy locations in India.• Lead the team of 3 domain experts (experienced Ayurveda physicians) and 65 Therapist and coordinated the efforts of the Administrative and Operations Head• Member for the ISO Internal Audit Team and also has promoted the organization towards the global podium for Medical Tourism, prepared the organization for the NABH Accreditation and JCI Accreditation. I have represented the organization over entire Asian Alternative Health Centers and had obtained Pevonia Asia “BEST AYURVEDIC CENTRE” Award for the organization.

LeNiol Health Resort is the only Ayurvedic Wellness Centre in Seychelles, Africa providing alternative health services, including Ayurveda, Yoga, Meditation, Reiki and Pranic healing. My responsibilities include:  Oversee and spearhead the Ayurvedic Center including Administration and Marketing actvities. Consultation and treatment designing/recommendation. Dietary and lifestyle recommendations. To take care of client experiences and quality of therapies. To up-grade the treatments and include new innovative treatments. To oversee and coordinate for therapy training. To teach and implement Ayurveda theory and practices for the staff, clients and public. Market the knowledge of Ayurveda to the Corporate in the process of wellness awareness.

• Responsible for development of new products and categories.• Medical writing on various clinical research activities • Provide technical support for queries on products• Constantly engage and maintain health relationship with medical fraternity.• Train and implement Ayurveda therapy and practices for the Corporate and Overseas clients.• Develop new products and provide necessary technical expertise. • Conduct Training and Implement Online Marketing Strategies for market expansion• Responsible for the development of the annual marketing plan and for controlling advertising, promotion and sales aids in accordance with the annual marketing plan.• Responsible for preparing product forecasts, and constantly monitoring inventory levels held at central and interstate warehouses including liaison with production to ensure supply timelines.• Liaise with the advertising agency regarding the product campaign including journal advertising, direct mail and conferences.• Develop product positioning and messaging, Product launch – plan the launch of new products and releases and manage the cross-functional implementation of the plan.• Responsible for International Market expansion and developed business plan to enter CIS Countries, African Countries and in South East Asian Countries.

Aarogya Chikitsalaya is an agency of AVP, Coimbatore with all-inclusive therapy facilities including OP/IP and also involved in exporting ayurvedic products of AVP. I was the in-charge of out-Patient and In-Patient department and was guiding / supervising a team of therapists.