Sravanthi Banneru

Dynamic and results-oriented professional seeking a challenging career that maximizes potential to benefit the organization while fostering a passion for continuous learning. Highly motivated and enthusiastic about acquiring new skills and methodologies, with a strong commitment to exploring innovative solutions that enhance existing knowledge. Demonstrates a proactive approach to personal and professional development, eager to embrace new opportunities for growth and improvement.

Pharma Benefit Analyst - Magna Infotech (Client: Optum Global Solutions) - Hyderabad

(2017-09 - 2018-02)

• Analyzed pharmacy benefit requests and gathered required data to ensure accurate implementation within the RxCLAIM (SXC) adjudication system.
• Designed and executed client-specific implementation plans, managing end-to-end processes in alignment with departmental protocols.
• Extracted and validated information by running queries in RxCLAIM, supporting precise plan setup and configuration.
• Developed and executed macros in RxCLAIM to streamline plan request implementations and improve efficiency.
• Conducted claim testing and validation to guarantee accurate adjudication and compliance with benefit logic.
• Maintained high-quality standards and met production turnaround times consistently.
• Adhered to departmental documentation protocols, ensuring audit readiness and compliance.
• Communicated issues and requirements promptly to stakeholders, enabling timely resolution of plan requests.

HIM Executive - Primera Technologies

(2018-03 - 2020-12)

• Serve as Senior Support Specialist providing documentation clarification and guidance to ensure accuracy and compliance.
• Assist team members in improving the quality of medical record documentation through knowledge sharing and support.
• Verify and authenticate aligned medical documents against practitioner approvals to maintain integrity.
• Compile and validate patient medical records and histories while performing detailed analysis of medical documentation.
• Review medical records to ensure completeness, correctness, and compliance with healthcare standards.
• Retrieve and deliver medical records requested by facility professionals for authentication and verification.
• Compile demographic data and treatment details, ensuring all orders are properly documented and aligned with patient care plans.
• Identify missing practitioner orders, initiate corrective actions, and request authentication to maintain compliance.
• Efficiently gather missing patient demographic data using Patient Search and EPIC systems.
• Manage and maintain Master Patient Indexes (MPI) to ensure accurate patient identification and record linkage.
• Provide clerical and administrative support across multiple healthcare documentation processes.
• Supported Prime Healthcare's 44 hospitals across 14 states, with direct responsibility for 14 key facilities, ensuring reliable medical records management across all sites.
• Ensured patient demographics and medical documentation were aligned with organizational standards and compliance requirements.
• Worked extensively in environments including OnBase Citrix Unity and Electronic Privacy Information Centre (EPIC) for medical records management.

Senior Associate - SS&C

(2021-02 - 2026-02)

• Process and adjudicate complex medical, dental, and vision claims in line with BCBS and CareFirst policies.
• Ensure accuracy and timeliness of claim handling within service-level agreements (SLAs).
• Investigate discrepancies or incomplete information, and take corrective action.
• Maintain compliance with HIPAA, CMS, and state insurance regulations.
• Prepare documentation for audits, and support internal/external audit readiness.
• Act as a liaison between members, providers, and internal teams to resolve claim disputes.
• Communicate claim decisions clearly to members and providers, explaining coverage and benefits.
• Utilize claims systems to track and update claim status.
• Generate reports on claim trends, error rates, and resolution timelines.
• Identify process inefficiencies and contribute to continuous improvement initiatives.
• Collaborate with cross-functional teams, such as underwriting, provider relations, and compliance.
• Train and mentor junior associates on claim adjudication and compliance requirements.
• Support regional provider/member engagement (CareFirst focus), and national standardization (BCBS focus).

Bachelor of Pharmacy - St. Pauls College of Pharmacy (2017-01)

Intermediate (Bi.P.C) - Sangam Laxmi Bai Junior College (2013-01)

S.S.C - Silver Drops High School (2010-01)