Jan 2020 – Nov 2024 · 4 yrs 10 mos · Greater Delhi Area · On-site

• Led operations for Travel & Medical Assistance, Travel/Health Claims, Emergency Alarm centre, & International Business for Insurance Assistance.
• Implemented digitalization and tech enhancements to optimize processes and ensure scalability.
• Developed and executed a comprehensive operational support strategy and road-map for the Delivery team, emphasising process optimisation, technological advancements, and resource allocation.

Oct 2017 – Jan 2020 · 2 yrs 3 mos · Gurgaon, India · On-site

• Heading Operations for Contact centre for Health Claims, Medical Room (OHC), & International Business of the Group leading a team of 600 plus team members and Health claims adjudication team of 1800 plus team members.
• Responsible for P&L overall direction, coordination, and evaluation of the Contact centre and claims team.
• Interact with top management of the clients for Service delivery/ Future business plans etc.
• Ensuring continuous improvement in process defects and creating improvement plan for defects.
• SLA Compliance and Call centre management, determine call centre operational strategies via conducting needs assessments, performance reviews, and capacity planning.

Apr 2016 – Jun 2017 · 1 yr 2 mos · Greater Delhi Area

• Managing Operations and devising strategies for various assistance projects
• Responsible for Effective & Efficient Delivery of Services of Operation as per agreed SLA’s.
• Complaints management – Handling complaints and performing trend analysis to understand and work on improvement areas of the project.
• Identify potential points of failure and build strong processes to anticipate them beforehand.
• Create, Coordinate and organize information and tools required for Operations team to perform their day to day task with utmost efficiency.
• Designing and identifying developmental needs for employee and ensuring they are equipped with right skill set for the job
• Compiling and Maintaining of Project SOP’s and Operations manual for seamless operative.
• Monitor and guide second level of command to handle day to day work and manage their respective teams and projects.
• Inform Executive management for any Ops concern and challenges and suggest course of action for immediate/ long term solutions.
• Involvement in Creating and maintaining BCP (Business Continuity) and CM (Crisis Management) for organization.

Aug 2014 – Apr 2016 · 1 yr 8 mos · Greater Delhi Area

• Heading Dental Healthline Centre, Team of 30 Dental Educators and Doctors to help customer with their dental related Queries, Grievance and FIRM management. Appointment booking as per the client requirement and Doctors availability for various clinics across North India.
• Managing Healthline Centre day to day activity, ensuring effective operational management. Formulating and implementing long term/short term strategic plans to achieve Sales, Quality and CSAT target.
• Identify and forecast any significant impact and underlying causes in Operations, Customer service & Satisfaction areas and develop & Propose the high level get well plans to senior management.
• Stakeholder management and Vendor management for smooth functioning and optimum services. Working closely with marketing team to ensure success of various short term campaigns to increase footfall in clinics.

Sep 2008 – Jun 2013 · 4 yrs 9 mos · Gurugram, Haryana, India

• Handling operations for Voice and Non Voice projects of Health Insurance Claims Adjudication, Policy updating, Eligibility Verification, AR, Benefit Setup, Billing, Coding, RCM and EDI.
• Proficient into leading & managing Healthcare Operations (Payer & Provider), Client Services, Project, Transition, Process Excellence, Business Development & Analysis, Revenue Management and MIS.
• Responsible for Project Management, Optimizing the Delivery, Operational metrics & Support front, Production Enhancement, & Quality Control thru operational planning & strategies.
• Responsible for Key Account Management, Client Servicing and Business development.
• Responsible for P&L, Performing C&B analysis for projects and providing details to higher management.
• Develop strategy for identifying processes that can be off shored existing and new client. Works closely with sales team, driving pre-sales initiative.
• Devise and implement Transition, Training plan & metrics in consultation with the VP Operations & business partners.
• Carefully check for variance at the pilot phase, identify cause and training need & ensure resolution.
• Ensure efficient production by balancing work factors such as optimal staff levels, anticipated workloads, peaks & spikes, desired revenue generation, considering technological capabilities, resource availability as per SLA’s and Revenue target.
• Act as Subject Metter Expert for the Team and DR’s, create manuals to smoothen the process and also prepare backups so that the work is not affected in the absence of the key resources.
• Set the vision, direction, and culture of the team by managing individual and team performance expectations and goals
• Perform Root Cause Analysis for all the critical misses and handling escalations.
• Plan and execute quality enhancement plan based upon client feedback and escalation

Apr 2007 – Jul 2008 · 1 yr 3 mos

• Inventory & Capacity Management for the LOB and the entire process. Ensuring clearance of ageing and distribution of work to the entire staff.
• Initiating and implementing new plans to deliver all the agreed SLA's.
• Ensure effective Staffing and break management for the LOB on the basis of forecasted capacity & revenue aspects.
• Assessment of competency levels and up-skill efforts through error analysis and auditing and providing regular feedbacks to help them to perform better.
• Responsible for optimizing the Operational metrics and the support functionalities, increasing the volume and quality of production through operational planning & strategies
• Handle all the calibration and resource balancing calls with the counter parts to meet the desired targets and quality measurements.
• Arrange calls between the claim adjudicators and the on shore quality department to fill in the knowledge gaps or to impart any new learning.
• Work on the performance, quality and personal grooming of a team of 20 associates. Doing appraisals, one-on-ones and measuring performance standards for team members.
• Analyze the operations and identifying key trends & scope for improvement in the performance of LOB.
• Perform Root Cause Analysis for all the errors encountered during the day to day activities and handling escalations.

Jul 2006 – Mar 2007 · 8 mos · Gurugram, Haryana, India

• Transitioned Uniprise Claims transaction and Adjustment process, ensure all the SLA remain green in pilot phase of the process.
• Meeting and agenda setting with the SME’s for training of the NHT’s and production agents.
• Use trending information to monitor Inventory workloads in order to maximize team efficiency..
• Support and supervise the agents to meet client expectations and deal with escalated issues/complaints such as compliance and Quality.
• Identify training needs for team and actively support, design and manage agents’ incentive scheme to ensure results are achieved. Also provide written and verbal appraisals.
• Monitor and assess the performance of agents and provide positive and constructive feedback in conjunction with Quality Coach. Monitor the targets and daily quality measures. Audit claims and provide feedback.
• Build team morale and resolve interpersonal and team conflicts.
• Encourage and act upon suggestions from team to increase operation efficiency.