Krish Ks

A competent professional with expertise in assessing the software requirements to deliver quality software products, seeking an opportunity to contribute to the professional growth of the organization. A technology driven professional with around 13.11 years of experience. 4.1 years as Business Analyst. Involved in full cycle Implementation of Projects and worked on all stages of Project Implementation such as Business Requirement gathering, Design, Development, and Testing.

Identifies the areas of improvement for the team and work with team members to continuously improve the process. Facilitated daily Scrum meetings, sprint reviews, and sprint retrospectives. Sound knowledge of Software Development Life Cycle (SDLC) and AGILE, SCRUM Methodologies.

Strong communication and interpersonal skills to interact with senior-level management regarding the implementation of changes. Good knowledge in performing UAT. Hands-on experience on JIRA tool and for creation of stories, managing product backlog, pulling reports.

Conducting tests, surveys, and workshops will be a part of daily activity.

Experience in managing a SCRUM team. Business analyst Exceptional communication, collaboration & team building skills with proficiency at grasping new technical concepts quickly and utilize the same in a productive manner.

Business Analyst - United Health Group - Hyderabad, Telangana, India

(2020-10 - 2021-10)

TOPS (The online Processing System) is one of the major claims adjudication payment systems in Tricare. It is the primary claim payment system for Uniprise Claims and is part of the UNET Suites of Applications. TOPS Auto adjudicates, finalizes, and sends daily Claims payment files to downstream with in turn generates checks and EOB's.

TOP'S processes 1 million Claims per day on an average that means the volume that flows into downstream Claims for EOB/Check creating just from TOPS. The finalized claims have out-of-pocket expenses like deductible, co-pay, co-insurance amounts to be paid by the member, etc. and the amounts payable to the provider.

• Comprehend business requirements/acceptance criteria and break them into functional specifications.
• Prepare Behavior Driven Development (BDDs).
• Coach team members on the Scrum framework and help them to understand their roles and responsibilities.
• Gathering high level requirements via continuous analysis meetings.
• Analyzing business data to identify trends and opportunities for improvement.
• Identifying and prioritizing enhancements to systems and processes.
• Facilitating meetings with stakeholders to gather input, communicate progress, and obtain approvals.
• High Level Requirement documentation preparation.
• Prepare Implementation Guide for client's consumption.
• Plan demos for users and other stake holders of the portal.
• Preparations of UI mock-ups and review the test cases.

Business Analyst - United Health Group - Hyderabad, Telangana, India

(2020-10 - 2021-10)

My UHC is a Web Customer Portal which offers Health benefits to the members. My UHC Offers Group Insurance to the members based on their eligibility. Eligibility is decided by the Specific Healthcare benefit a member has chosen, such as medical or drug eligibility.

Users can submit claims, appeal claims, check account balances, view claim summary, EOB's, and the statement through this Portal. When user submit the Request, it trigger through UPM call through foundation view and get the response source from the system.

• Attend the Business requirement review/walkthrough calls given by Client; understand the requirements.
• Implement requirements under, Agile development methods.
• Create high level Epics in JIRA.
• Break them down into User Stories attainable in a sprint.
• Comprehend business requirements/acceptance criteria and break them into functional specifications.
• Prepare Sprint retrospective report, Product backlog, Change request log and User stories document.
• Prepare BRD (Business Required Document).
• Supported the project teams with the functional requirements.
• Manage triage calls involved with all the clients, SME's and developers.

Analyst - United Health Group - Hyderabad, Telangana, India

(2019-08 - 2020-09)

New Improved Claims Exchange (NICE)- Is a claim engine for west region providers who contracted and leased with United Health Group. Claims are processed in NICE platform for associated providers NDB-NICE Automation tool is a tool which automatically loads the information from one system to another System. NDB is the source of truth for the providers who are contracted to UHC.

NICE is the platform for the claims to process for UHC-WEST region providers who are leased to UHC. So, the provider data needs to update in NICE system for the claims to processed accurately. Provider updating in NICE system is complex task as it has several screens to be update.

Automation tool has developed so that once data is updated in NDB user need to input values to tool and data is captured from NDB and load the NICE System accordingly.

• Comprehend business requirements/acceptance criteria and break them into functional specifications.
• Analyzing the production defects and finding the root causes for the defects.
• Gathering high level requirements via continuous analysis meetings.
• High Level Requirement documentation preparation.
• Providing assistance to develop and testing team to understand the requirements and use cases
• Prepare Implementation Guide for client's consumption.
• Working in preliminary, impact and gap analysis for Change Requests.
• Plan demos for users and other stake holders of the portal.
• Preparations of UI mock-ups and review the test cases.

Benefit reverification Co-Ordinator - United Health Group - Hyderabad, Telangana, India

(2014-04 - 2019-07)

• Worked closely with provider's office as we receive the new plans and benefits, on regular basis.
• Reaching targets with in the TAT with 100% accuracy and helping to other team members to complete the total volume of the day
• SPOC for maintaining the work types and allotment of work and System down time reports.
• Depending on the Claim form & Patient's Criteria we have to Pull-up the Information from Insurance Company.
• Coordinate the assessment, development and effectiveness of subordinates. Meet and or exceed client and organization expectations.

Senior Claims Associate - United Health Group - Hyderabad, Telangana, India

(2010-12 - 2014-03)

• Need to verify the Customers Eligibility in the websites and if required we will call and get the member benefits.
• We should be able to handle the provider's requirements and deliver the plan on time as well as to resolve queries which claim adjudicating people also required important information regarding a particular plan to pay the claim as per plan benefits; Hence they require some information like medical records.
• Reviewed and processed medical health claims for Self-Insured Groups including verification of coverage, COB and adjudication of claims.
• Depending on the Claim form & Patient's Criteria we have to Pull-up the Information from Insurance Company.
• Coordinate the assessment, development and effectiveness of subordinates. Meet and or exceed client and organization expectations.

Tech Support Executive - Value Labs Private Limited - Madhapur, India

(2007-09 - 2009-09)

• Customer verifications pertaining to Address, Social Security No, contact number, banking details and Review & Validate Customer Insurance Claims, Credit Card Bills, and Medical Bills.
• Update Customer on data mismatch, incorrect details and update the records appropriately.
• Inbound support for Claims exceeding 30 days and Outbound calling to update customers on Claim status, Data Verification.
• Coordinate the assessment, development, and effectiveness of subordinates. Meet and or exceed client and organization expectations.
• Responsible for Acquisition of new customer base and deepening the relationship through continuous cross selling the entire gamut of IT, ITES Solutions.

Masters of Librarian - Library Science - Madurai Kamaraj University

Bachelor of Librarian Sciences Degree - Library Science - Madurai Kamaraj University

Bachelor of Arts - Political Science