Shivam V.

Directed a team of over 50 associates by assigning tasks and managing workload distribution to maintain daily and monthly production targets. Oversaw simultaneous management of three projects, maintaining delivery timelines and standards in line with SLA commitments. Served as Project Lead and Primary Point of Contact, handling stakeholder communication, client management, and escalations. Monitored KPIs, productivity metrics, quality scores, and SLAs to inform process adjustments. Facilitated regular performance reviews with feedback and coaching to increase team engagement. Ensured compliance and timely collections within regulatory requirements. Coordinated with operations, quality, training, and senior leadership to meet business objectives. Led process improvement initiatives focused on operational efficiency and reducing turnaround time. Identified team performance gaps and implemented action plans. Maintained data accuracy for internal and client audits, driving continuous improvement aligned with organizational goals.

Examined denial trends, payer behavior, and reimbursement data to guide resolution strategies. Interacted with stakeholders to determine root causes of claim rejections and recommend corrective actions. Assisted in assembling operational reports and data summaries for tracking collections and evaluating process effectiveness. Maintained and updated process documentation and training resources based on analysis findings. Verified compliance with payer policies and business rules to minimize repeat denials.

Supervised assignment of tasks and balanced workloads for a team of 50+ associates to consistently reach production goals. Managed end-to-end delivery of multiple projects, upholding project timelines, adherence to quality, and SLA requirements. Functioned as the Primary Point of Contact for clients, facilitating stakeholder communications and managing client escalations. Oversaw performance monitoring, conducted quality analysis, and led regular coaching interventions. Supported compliance through timely collections and adherence to business standards, while collaborating across operational, quality, training, and leadership teams to achieve targets. Drove initiatives for process optimization, improved turnaround time, and maintained high standards in reporting and documentation.

Reviewed denial patterns and payer reimbursement processes, contributing to the development of data-driven solutions. Collaborated with internal stakeholders to diagnose and address the causes behind claim rejections. Supported the creation of operational reports and monitored collections data. Participated in updating process documentation and training guides. Ensured adherence to payer policies to reduce recurrent denials.

Coordinated activities for a large group of associates by distributing work and tracking production metrics to reach business targets. Ensured seamless management and delivery of concurrent projects within set timelines and SLA requirements. Maintained ongoing client and stakeholder communication as the project’s primary contact and handled issue escalation. Regularly assessed KPIs and productivity data to promote continuous team improvement. Arranged performance discussions and feedback sessions while maintaining accurate records for audit purposes. Initiated process improvements and collaborated with cross-functional teams to enhance operational outcomes and compliance.

Performed workflow analysis across denial management, EBV, and prior authorization functions. Recognized gaps and inefficiencies in processes to foster improved claim accuracy and reduced turnaround times. Supported data validation and produced reports related to payment posting and appeal outcomes. Worked in collaboration with operations teams to link business requirements with execution protocols, and contributed to maintaining SLA compliance via performance monitoring.

Investigated payer collections, denial reasons, and aging reports to detect potential revenue losses. Offered data-driven support for decisions intended to enhance recovery rates. Documented recurring process issues and contributed to improvement initiatives. Maintained data accuracy and compliance throughout claims and appeals processing.