Samitha M
B-704, SJR Spencer, Varthur Main Road, Marathahalli Bangalore-560037
Phone : 9986015673, 41155610 Email :
[email protected]
Experience Summary: Summary: Over Over 10 years years of expe experi rien ence ce work workin ing g for for vario various us orga organi nisat satio ions ns viz. viz.,, Retail Retail,, HealthCare (Insurance, Medical Transcription and the Pharma Industry). Collate the business requirements from business team and delivering Business Requirement Specifications (BRS) to design & construction team. Proven ability to Transition pharmacy and insurance processes from the US. Strong domain knowledge knowledge and expertise in Pharmacy, Pharmacy, Health and Worker’s Compensation Claims management. Comp Complet leted ed and and succe successf ssful ully ly impl implem emen ente ted d the the pharm pharmac acy y proc process ess from from Minneapolis to Bangalore Comp Comple letted the Proc Proces ess s Map Mappin ping & migra igrati tio on plan plan for for the the Work Worker ers s Compensation Claims process to be migrated from San Diego to Bangalore. Worked in San Diego for 7 months.
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Education Qualification: B Pharmacy: PES College, Bangalore University MBA
: Indira Gandhi National Open University
Experience Summary Business Analyst with Target India from July 2007 to current.
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Discussing the Business Requirement with Business Team and authoring the requirement work book for Rx – Process ing project in the program. Transition of pharmacy drug file project from Minneapolis, US. Domain specialist for the development of a new pharmacy application Assisting both construction and testing teams involved in developing a new pharmacy application with domain-specific inputs Product Adds: Responsible for accurate and complete product and clinical information setup of a new product product launch before product product arrives in stores, including the review of subsequent information to ensure complete product add. Product Updates: Responsible for managing drug file updates from Target’s drug information sources. Cost Changes: Review weekly cost changes, evaluating information from multiple sources. Develop pricing recommendation for approval by Healthcare Management. Preferred Products: Maintain PDX to reflect the the current status status of preferred preferred generic products.
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Store Support: Responsible for researching, problem-solving and resolution of product related issues. Trend Analysis: Analyze eform/update trends affecting drug cost, drug drug pricing, gross margin and product selection; communicate concerning trends to Healthcare Management. Process Documentation & Improvement: Communicate potential solutions or enhancements to drug file processes for incorporation into Rx procedure/process materials.
Certifications: Certified yellow belt, Six Sigma Certified in Merchandizing 101 Associate Business Analyst with Cambridge Solutions United States Aug 2006 to Apr 2007. Role: Transition of Workers Compensation claims from San Diego, US •
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Laid down the migration plan and made the process improvements to ensure the workers compensation claims process would be migrated to India. Has been onsite in San Diego for 8 months to e nsure smooth transition. Completed the onsite study and documented the processes. Implemented changes to the processes to ensure that the processes can be migrated to Bangalore.
Certifications: Certified in California Worker’s Compensation 101 Certified in Utilization Review, Penalties and Apportionment. Certified in Adjuster training in Ethics Certificate in Rotator Cuff Injuries.
Cambridge Solutions, Bangalore, India Team Lead – Feb 2004 to Aug 2006: •
Cambri Cambridge dge Soluti Solutions ons is one one of the India’ India’s s busine business ss process processes es outsou outsourcin rcing g compan com pany y with offices offices in US, Austra Australia lia,, India India and UK. Cambri Cambridge dge provid provides es process consulting, financial and accounting services, transaction processing, claim management and contact centre services for various financial services sector viz., Banking, Mortgage and Insurance
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Involved in Migration/Transition of Insurance/Financial projects to India Documenting the migration plan and ensure proper process transition. Manage operations to ensure that the SLA has been met Document business processes and metrics requirement to ensure effective and efficient process management Ensure profitability of the project Managed a team of 12 Claims Examiners & Claims Service Representatives. Manage Client relations
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Maintain and generate reports on a weekly and monthly basis. Train and mentor new recruits and conduct refresher trainings for existing members. SPOC for the BPU Bangalore team Staff the team per requirements to ensure uninterrupted service levels. Set work schedules based on inventory.
GE Capital International Services as Senior Process Associate –Insurance Claims from 2002 May to 2004 January As part of the pilot team, successfully transitioned the GEFA-ESG process from USA to India. Manage a team of 12 medical claims adjudicators Approver for checks up to $ 25,000. Maintain a procedural and payment accuracy level of 99.8% as part of the Six Sigma Process. Document and reporting the weekly and monthly dashboards for the process. Ensure optimal use of resources by managing shift utilization. Conceptualize and develop online reference web page as part of Six Sigma Process improvements. •
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Training Record: Underwent extensive training (Health Insurance Association of America), Medical Terminology and Effective Communication at GE Capital, Bangalore. Underwent extensive training in Health Insurance Claims Processing using the RIMS Mainframe at GE Insurance Headquartered at Arlington, Texas, USA, for 4 months (June, 2002 to Sept, 2002) Underwent regular classroom training in Quality and Six Sigma Methodology and learnt to apply various Six Sigma tools in improving the process. •
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Underwent training in Time Management, Presentation Skills, Managing Stress, Solving Problems as a Team, Communication Skills and Positive Attitude through class room courses and GE’s e-Learning portal. Cbay Scribe: Worked as a Quality Analyst (Medical Transcription) from 2000 Sept to 2002 May. CbaySystems utilizes in house software to provide efficient, quality-driven and costeffective medical transcription services hospitals and physician practices. Maintain accuracy Levels of 98% and above Mentor medical language specialists for enhancement of their performance. Conduct training on an as needed basis. • •
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Ajax.com (Medical Transcription) (1999 Sept to 2000 Sept.) •
Proofing of files from Proofer Level 1
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Coordination of a group of M.L.S
Pfizer Ltd Worked as Business Development Officer fr om 1998 Jan to 1999 Sept. • •
Organize Seminars with Doctors Interview Doctors and collect data.
