Benefits Operations Manager - WIPRO LTD - Noida
(2022-09 - 2026-06)
Manage administration of US employee benefit programs, including health & welfare, leave programs, retirement plans, and other employer-sponsored benefits.
- Governed end to end data processing, audits, mass uploads, vendor file feeds, and issue resolutions.
- Ensure accuracy and compliance across benefits transactions, documentation, and governance controls
- Collaborate with vendors, payroll, compensation, and HR teams for seamless benefits operations
- Respond to complex or escalated benefits queries and support audits, regulatory reporting, and documentation.
- Monitor process performance, identify gaps, and drive continuous improvement in benefits data workflows
- Provide guidance, training, and quality oversight to junior team members
- Support transition, automation, and system enhancement initiative
- Own overall performance of the team and ensure delivery of agreed client outcomes.
- Consistently meet or exceed internal and client Service Level Agreements (SLAs).
- Drive high standards of service delivery through effective planning, execution, and monitoring.
- Proactively manage risks, escalations, and mitigation plans to ensure uninterrupted delivery.
- Build a sustainable delivery model with a strong focus on quality, efficiency, and client satisfaction.
- Lead, coach, and develop team members to drive performance
- Responsible for auditing for ongoing process on the client.
- Responsible to lead and drive client facing mails and project on time within threshold with timely updates to stakeholder.
- Ensure on time, high quality delivery of all ongoing work to plan sponsors and participants.
- Drive operational efficiency through process improvements and effective resource planning.
- Build strong client relationships and act as a trusted point of contact for clients and partners.
- Maintain regular and proactive communication with team of 7FTEs and leadership to keep them informed about project progress.
- Actively engage with global and regional independence team to implement any process changes, enhancement and improvement to ensure their expectations are met.
- Develop effective conflict resolution and escalation management strategies to address and resolve any issues or escalations promptly and professionally.
- Establish and monitor key performance indicators (KPIs) related to client management to ensure high standards of service delivery.
- Engage in reporting activities to support internal and external team's requirements.
Management Trainee - GENPACT INDIA PVT LTD
(2020-12 - 2022-09)
- Conduct quality audits and share feedback with resources.
- Drive Continuous Improvement – make recommendations and drive improvement
- Data analysis and creation of reports and presentations.
- Strengthen quality management process to improve quality delivery.
- Ensure data management for all results and be accessible without any delay.
- Participate in internal and external calibration to ensure consistent scoring and feedback delivery
- Monitor team members and able to provide mentorship whenever needed.
- Report building with the Internal & External partners.
- Ensure that the highest possible levels of customer service and delivered at all times.
- Determine accurate payments criteria for clearing pending claims based on defined Policy and Procedure.
- Validate Member, Provider and other Claims information.
- Scrutinising Medical Claims Documents and settlements.
- Continuously analyses on Claims products like- Disability, Wellness, Accident, Sickness Claims.
- Preparing SOPs and managing calls with onshore team.
- Organising and completing tasks per Assigned Priorities.
- Resolving complex situations following pre-established.
- Developing and maintaining a solid working knowledge of the Healthcare Insurance industry and of all Products, Services and Processes performed by the Team.
- Assisted leadership with critical tasks to optimise business continuity.
Senior Associate - R1 RCM Global Pvt Ltd
(2018-12 - 2020-12)
- Review medical records for completeness, accuracy, and timeliness.
- Organise and maintain the clinical databases
- Electronically record data with information technology systems.
- Find new ways to protect patient privacy in health care settings.
- Manage other staff members in healthcare information positions.
- Work with other health care staff to perform analysis of patient data.
- Report on patient data as part of studies and analysis.
- Performance coaching of team members along with production and quality standards.
Sr. Claim Associate - United Health Group
(2016-02 - 2018-09)
- Manage claim inventory and distributes workload to unit staff.
- Monitors employee quality /production so departmental standards are developed and met and/or exceeded; Updates this standards as necessary.
- Monitors turn-around time of claims processing on weekly basis, ensuring that performance standards are being met and/or exceeded. Inform Manager of status of work flow.
- Audits individual employee's daily production to identify areas which may need improvement; Reviews these scores with the employee not less frequently than bi-weekly.
- Coordinates training for all news existing personal on all aspects of job duties with claim trainer.
- Identify system problems and potential work flow issue; Inform Manager of issue(s) and potential solutions
- Continuously analyses, reviews, and attempts to streamline processes and workflows.
- Communicates with unit staff via weekly meetings to discuss changes to policies/ procedures, problem identification and resolution, and implementation of new processes.
- Researches and provides documentation to help resolve issues raised by administration and/or Providers in regard to claims or claims processing; Reviews with Managers
- Provides excellent customer service for Providers, Members and other external source.
Customer Service Representative - Wipro Ltd. - Noida
(2012-06 - 2013-07)
- Manage large amounts of incoming calls and generate sales lead.
- Identify and assess customers' needs to achieve satisfaction.
- Build sustainable relationships of trust though open and interactive communication.
- Provide accurate, valid and complete information by using the right methods/tools.
- Meet personal/customer service team sales targets and call handling quotas.
- Handle complaints, provide appropriate solutions and alternative within the time limits; Follow up to ensure resolution.
- Keep records of customer interactions, process customer accounts and file documents.
- Follow communication procedures, guidelines and policies.
