Arunkumar

Process Lead – Property & Casualty Insurance

ReSource Pro

Aug 2025 - Current (1 year 3 months)

• Lead end-to-end P&C insurance operations for 3 US-based carrier clients, managing a team of 10 analysts
with 98.5% SLA adherence across all accounts.
• Conduct 150+ underwriting file reviews monthly, validating documentation completeness, exposure
analysis, and risk categorization with 99.2% accuracy.
• Perform broker identification and compliance validation including producer licensing, agency
appointment checks, and commission structure reviews for 50+ brokers quarterly.
• Evaluate policy submissions, endorsements, and renewals, identifying coverage gaps and underwriting
exceptions that reduced client risk exposure by 25%.
• Reduced rework rate from 12% to 4% by implementing standardized quality c

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Senior Quality Analyst – Revenue Cycle Management

Sagility Pvt. Ltd. (Formerly HGS Healthcare)

May 2022 - Jul 2025 (3 years 3 months)

As a Senior Quality Analyst in Revenue Cycle Management, I performed over 200 comprehensive audits monthly across end-to-end processes, including medical billing, coding validation, and accounts receivable follow-ups. I validated ICD-10, CPT, and HCPCS coding accuracy, maintaining a 98.7% compliance rate against payer guidelines and reimbursement policies. My analysis of denial patterns and underpayment detection identified revenue leakage worth over $120K quarterly, improving the net collection rate by 18%. I implemented structured Root Cause Analysis (RCA) and Corrective and Preventive Action (CAPA) plans that reduced recurring billing errors by 35% within six months. Additionally, I monitored productivity, turnaround time (TAT), and qual

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Subject Matter Expert (SME) – Claims Adjudication

Sagility Pvt. Ltd.

Jan 2020 - Apr 2022 (2 years 4 months)

• Managed complex claims adjudication scenarios across multiple US payer systems, resolving 95%
of escalated cases within defined turnaround times.
• Provided operational guidance and real-time support to a processing team of 12 associates,
reducing average claim processing time by 20%.
• Conducted documentation reviews for 100+ claims weekly, ensuring regulatory adherence and
payment accuracy at 99%+ rate.
• Delivered 15+ structured training sessions to new hires, reducing onboarding learning curve from 8
weeks to 5 weeks a 37% improvement.
• Served as the primary escalation point for client queries, maintaining 98% client satisfaction score.

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Senior Associate – US Healthcare Claims

Sagility Pvt. Ltd.

Mar 2017 - Dec 2019 (2 years 10 months)

• Processed and audited 80+ US healthcare claims daily with 98.5% accuracy, ensuring regulatory
compliance and timely claim settlement.
• Handled 50+ client escalations monthly, achieving 97% resolution rate within defined turnaround
times.
• Conducted pre-settlement documentation reviews to verify completeness and compliance,
reducing claim rejection rate by 15%.
• Consistently ranked among top 3 performers in a team of 20, recognized for zero-defect processing
and operational discipline.

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Arunkumar

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