Thejesh Kumar

Thejesh Kumar Email and Phone Number

Principal Consultant - US Healthcare Domain
Thejesh Kumar's Location
Bengaluru, Karnataka, India, India
Thejesh Kumar's Contact Details

Thejesh Kumar work email

Thejesh Kumar personal email

n/a
About Thejesh Kumar

Thejesh is a certified RCM specialist and have immense knowledge in areas related to RCM Solutions and offerings. I have also done certifications in AHM, PAHM, AHIP and CMS Programs. I have worked and designed solutions for ICD 9 -10 transition, Care Management and have top notch Claims Management & Adjudication knowledge and exposure.I have previously worked on various projects involving transition from 4010 to 5010 and have immense knowledge in areas related to ANSI X12 transactions,Practice Management System, Claim Submissions, Provider Data & Contracted rates management, Cash Posting along with payer business offerings such as Claims life cycle, Enrolment, MSP, MAP, Benefit plan setup, Health Plans etc.. I have vast experience in Obamacare related regulations having designed products related to ACO solutions, HIE and HIX. I am currently working on solutions for ANSI X12 7030 transition, Payer Guidelines for Qualified health plan, Integration Hub connecting PMS, EHR and extrenal vendors using EDI and HL7 standards.

Thejesh Kumar's Current Company Details

Principal Consultant - US Healthcare Domain
Thejesh Kumar Work Experience Details
  • Innova Solutions Usa
    Manager - Project And Business Analysis
    Innova Solutions Usa Oct 2014 - Sep 2017
    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
  • Capgemini
    Lead Business Analyst
    Capgemini Apr 2013 - Aug 2014
     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
  • Htc
    Business Analyst
    Htc Mar 2011 - Apr 2013
    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.
  • Hgs - Hinduja Global Solutions
    Group Lead
    Hgs - Hinduja Global Solutions Jan 2005 - Mar 2011
    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

Thejesh Kumar Skills

Requirements Analysis Business Analysis Team Management Software Project Management Sdlc Project Management U.s. Health Insurance Portability And Accountability Act Us Healthcare Healthcare Reimbursement Healthcare Management Agile Us Healthcare Product Owner Process Improvement Vendor Management Requirements Gathering Software Development Life Cycle

Thejesh Kumar Education Details

Frequently Asked Questions about Thejesh Kumar

What is Thejesh Kumar's role at the current company?

Thejesh Kumar's current role is Principal Consultant - US Healthcare Domain.

What is Thejesh Kumar's email address?

Thejesh Kumar's email address is th****@****haa.com

What schools did Thejesh Kumar attend?

Thejesh Kumar attended Kazian School Of Management, Bangalore University.

What skills is Thejesh Kumar known for?

Thejesh Kumar has skills like Requirements Analysis, Business Analysis, Team Management, Software Project Management, Sdlc, Project Management, U.s. Health Insurance Portability And Accountability Act, Us Healthcare, Healthcare Reimbursement, Healthcare Management, Agile, Us Healthcare Product Owner.

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