Thejesh Kumar Email & Phone Number

Taipei City, Taiwan

Project & Operations Management: Client & Customer Management  Planning & Process Management  Forecasting & Schedule Management Resource allocation & Effort Management Goal Setting and Milestones Management Estimation & Project Cost Management  Stakeholders , Scope & Standards Management  Risk Register & Risk Management Tasks, Timeline, Budget & Change Management Delivery & Quality Management  Requirement & Documentation Management Strategic Planning & Decision making Employee Surveys & Customer/Client Surveys Negotiation Management; Communication Log Management

 Work towards reducing waste, create solutions, complete projects in time, improve efficiency, document the right requirements Experienced in SDLC and application support in a BA role and follow Waterfalland Agile methods in delivering a project Identify and gather requirements for the project which helps define the business needs Conducting / Participating in JAD (Joint Application Development) sessions and documenting requirements Conducting requirement walkthroughs and requirements review Preparing Business requirements document and block diagrams, update the requirements using the MOSCOW techniques. Perform the SWOT analysis and use of WHY logic during brainstorming sessions, GAP analysis Participation in different phases of the project, Assist design and development on Business logics Participating in change request process, test strategies, UATs, project plans Talk to the stake-holders to understand each aspect of the requirement and determine the corresponding system impact, follow up with development team on the status of the requirements Analysis of all SLA &quality metrics of all teams, Billing, Attendance, Resource Planning, business workflows Interface between the clients and the organization for their respective projects, conducting conference calls on projects/processwith the clients Ensure all documentation resides in a central area easily accessible and Ensure company templates are used, with version numbers and standard formatting

Chennai

 Comparing process performance against benchmarks and improving the process efficiency. Capacity planning and Manpower estimation provide business analytics insight on performance highlights/lowlights.  Ensure SLA compliance with respect to TAT and Quality Taking care of internal metrics such as performance incentive, overtime, appraisal, promotion nomination and training. Promoting knowledge sharing activities by policy change updates and process change updates Set individual and team targets, conducting regular reviews, counseling & feedback; conducting team reviews Ensure that SLAs, Vendor management functions that include contracting, resolution of issues and compliance to payments terms are met Determining training needs of team members and conducting suitable training programs to enhance their operational efficiency leading to increased productivity and Quality deliverables Contributed to improving the way we operate by innovation and the use of best practice processes. Responsible for Identifying opportunities on process/system improvement, analyze and summarize the data findings to the senior management Realizing process improvements, applying different techniques in different areas to enhance productivity & profitability Preparing CAPA & RCA for all internal & external errorsRole of a Business Analyst.

Bengaluru Area, India

 Deep knowledge of Health care life cycle from Claims Data entry to EOB/EOP generation (Underwriting-Member Enrollment – Provider– Benefits set up- EDI transactions – Claims Processing), provider Revenue Cycle Management, provider contract, affiliations Knowledge of the Operational, support and strategic functions of a payer and provider Knowledge and experience of handling complex professional (HCFA 1500), institutional (UB 04), Medicare, Medicaid, Vision, Fraud and Subrogation claims and also claims pertaining to overpayment Exposure to EDI & OCR, Contract management, Claim submissions, Accounts receivables Knowledge of plan benefits, products, accumulators, Member enrollment, premium billing Setting Business rules for claims to auto adjudicate without manual intervention and setting up all plans & procedures related to the same Handled domain specific training on US Healthcare(Payer and Provider specific)People & Training Management: Conflict Management Positive - Constructive Feedback Management Timely Reviews, Appraisals Management Set Performance Expectations & Delegation Management  Professional & Career Development Management Motivation & Extra Curricular Activities Management Identify - Nurture Skills& Team Management CAPA & RCA Management Process & Product Continuous Learning Management Mentoring and Coaching Management

Master Of Business Administration (Mba), Project Management, A

Bachelor'S Degree