Swapna P
US Healthcare Operations Specialist
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About
Results-driven US Healthcare Operations Specialist with 4.7+ years of experience in medical claims processing, adjudication, and benefits administration. Expertise in payer guidelines, HIPAA compliance, claims lifecycle management, and dental resolution. Proven track record of improving claim accuracy, maintaining SLA/TAT compliance, and handling high-volume workloads with precision.
Experience
Healthcare Analyst – Operations - NTT DATA Services
(2022-12 - 2024-05)
- Processed and adjudicated high-volume US healthcare claims in compliance with payer policies.
- Resolved claim denials, underpayments, and discrepancies.
- Ensured HIPAA compliance and met productivity and TAT benchmarks.
- Collaborated with teams on complex claims and supported audits.
Benefits Administration Associate - Conduent
(2020-06 - 2022-10)
- Managed employee benefits including enrollments and eligibility verification.
- Maintained HIPAA compliance and SLA standards.
- Handled high-volume transactions with accuracy and documentation.
Education
B.Sc. - Computers - Government Degree College for Women, Hyderabad (2015 - 2015)
Intermediate - Maharshi Vedha Vigyana Mahavidyalaya (2012 - 2012)
SSC - Maharshi Vidya Niketan, Hyderabad (2009 - 2009)
