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PROFESSIONAL SUMMARY:

• Business Analyst in requirement gathering, analysis, and business processes management with a strong knowledge of System Development Life Cycle (SDLC) using Waterfall methodologies. Worked extensively in Health care and Property & Casualty Insurance domains in diverse business and technical environments.
• Worked on healthcare standards such as DPA, HIPPA 4010, 5010& BS7799.
• Handled renewal accounts within underwriting authority for Property, General Liability, Business Automobile, Umbrella Liability, Crime and Workers’ Compensation.
• Effectively handled General Liability and Workers’ Compensation audits on a monthly basis.
• Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
• Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
• Well Versed with various OLAP Tools such as Cognos BI (8.2, 8.4 and currently working on 10.1).
• Extensively involved in Developing Reports using Report Studio and Query Studio as per the business requirements.
• Created different kinds of reports including Charts, Dash Boards and Master Detailed Reports in Report Studio.
• Preparing Daily Service Reports; KPI, Scorecards, Service Level Reports and keeping Track of Missed Goals.
• Having good problem solving and analytical skills. Highly motivated, quick learner.

PROFESSIONAL EXPERIENCE:

Confidential

Lead - Client Service Representative (Sr. Business Analyst)

Technologies: Cognos 8.2 BI, Oracle and Window XP, Mainframe AS400, PowerPoint, MS Word, MS-Excel

Responsibilities:

• Everyday task making Daily Service Report and different clients.
• Monthly basis working on Scorecards, KPI reports & SLR.
• Lead of the Reporting and Performance management team and Leading PMO tasks and Audit Projects.
• Strong analytical, communication, presentation and documentation skills.
• Create, update operational documentation such as system documentation, process documentation, support documentation, etc in MS excel and MS word.
• Creating automated Six Sigma Dashboard / Scorecards, Global Metrics Report & Process Scorecards.
• Transiting new project reports and analytical activities for the Business Unit.
• Developed ad-hoc reports using query studio.
• Gather/Design report requirements and build sophisticated reports/ scorecards, analysis and queries.
• Created customized reports using calculations, filters, and conditional formatting in Report Studio.
• A consisted performer with track record of consistently setting performance benchmarks and completing assignments well within deadlines.
• Cognos support work including scheduling, running, troubleshooting report issues.
• Working on Transition and improvement projects.
• Troubleshooting the End to End Reports working on SQL Severs.
• Quality Management Representative of the team. Responsible for representing team during audits as per ISO standards.
• Capable of developing and implementing new standard policies and procedures as well as improvements to existing policies and procedures.
• Represented Service Management Team for Audit Successfully, 100% compliance.
• Quality Management Representative/ Business Excellence SPOC from the team for 5 years.
• Deploying Quality Management Standards for the team which include 80 documents.
• , coaching and mentoring new resources on
• Preparing and distribution of Business Unit’s reports.
• Managing & providing periodic metrics and analysis for Business.
• Creating new reporting templates for more effective and efficient data analysis.
• Other ADOC tasks
• Handling tasks related to clients Services Management.
• Working as Service Delivery Co-coordinator for multiple accounts.
• Working on Remedy 7.5 and worked on Remedy 4 too.

Confidential

Lead- Client Service Representative

Technologies used: Mainframe, MS -Excel, PowerPoint, MS - Word and SQL

Database: SQL Server 2005

Responsibilities:

• Active participation in the weekly operations / quality review conference call with clients.
• Create /Review dashboards, data reports on a daily/weekly basis, provide feedback, prepare action plans.
• Worked very closely with client to proactively understand business needs and solutions to anticipated issues.
• Developed Complex reports by using Conditional formatting.
• Queried from different database tables as per the requirement.
• Scheduling the reports.
• Ensure that the quality of transaction is under compliance with predefined parameters as defined by Process Excellence.
• Testing reports using review checklists for Quality Assurance before delivering to the end users.

Confidential

Lead- Client Service Representative

Technologies used: Mainframe, MS -Excel, PowerPoint and MS - Word

Database: Ms Access

Responsibilities:

• Active participation in the weekly operations / quality review conference call with clients.
• Analyzing request and task requirements provide Estimation for tasks and understanding the requirements.
• Create /Review dashboards, data reports on a daily/weekly basis, Score card and provide feedback, prepare action plans.
• Actively participated in Six Sigma Project within Property & Casualty.
• Active member of BOG Project also Conduct on organizational standard processes “Induction”.
• Lead/ Support on various business improvement initiatives in progress/ planned like Allocation of work.
• Worked very closely with client to proactively understand business needs and solutions to anticipated issues.
• Managing multiple lines of business and ensure that the assigned targets are met in accordance with SLA and Internal standards.
• Ensure that the quality of transaction is under compliance with Predefined parameters as defined by Process Excellence.
• Conducting weekly review of ongoing maintenance tasks.
• Providing Enhancement to the existing applications.

Confidential

Sr. Client Service Representative

Technologies used: Mainframe, MS -Excel, MS - Word and Citrix Server client

Database: MS Access

Responsibilities:

• Handled all correspondence, records, and reports for processing.
• Calculate premiums, refunds, commissions, adjustments, using Insurance rate.
• Preparing Expiration chart of the various Policies.
• Handled various insurance accounts: Auto Insurance, Home Insurance, Boat Insurance, Excess Liability, Commercial Insurance, Business owners, Church Insurance, Farmers Insurance.
• Endorsements to modify, update various coverage in the existing policies.

Confidential

Joined as Client Service Representative

Technologies used: Mainframe, MS -Excel, PowerPoint and MS - Word

Database: MS Access

Responsibilities:

• Handled all correspondence, records, and reports for processing.
• Evaluated application forms, inspection reports and insurance maps.
• Handled Underwriting and pricing of renewal accounts within underwriting authority for Property, General Liability, Business Automobile, Umbrella Liability, Crime and Workers’ Compensation.
• Calculate premiums, refunds, commissions, adjustments, and new reserve requirements, using insurance rate standards.
• Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.
• Modify, update, and process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
• Developed a strong understanding of insurance policies and legal issues through completion of a series of INS classes coupled with in-depth, multi-week claims .
• Trained all incoming employees on all aspects of the job.

Confidential

Client Service Representative

Technologies used: Web based application, MS -Excel, and MS - Word

Database: MS Access

Responsibilities:

• Review insurance policies for coverage decisions, preparation of coverage letters, and makes recommendations.
• Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
• Auditing and Skip tracing the property and casualty Auto Accident cases.
• Contact via emails and/or interview statements of claimants, doctors, medical specialists, Policies Report, witness statement or employers to get additional information.
• Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
• Preparing the MIS including daily accuracy & productivity report based on the audit result.
• Maintaining monthly process report by mapping the daily volumes, productivity and accuracy per individuals.
• Maintaining the Workflow documents as well as the Work Instruction of the Process.
• Keeping the track of the turnaround time.

Confidential

Process Associate

Technologies used: Customize Web based application

Database: MS Access

Responsibilities:

• Processing of health insurance claims.
• Quality check of the insurance forms and making a judgment call to approve them.
• Meeting daily targets in terms of productivity, accuracy and turn-around time.
• Contact via emails and/or interview statements of claimants, doctors, medical specialists, Policies Report, witness statement or employers to get additional information.
• Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
• Keeping the track of the turnaround time.