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Shamna shajahan, CLAIM ANALYST

Shamna shajahan

CLAIM ANALYST·CONDUENT Inc, BUSINESS OPERATIONS SOLUTIONS

Saudi Arabia

Bachelor's degree, Electric And Communication Engineering

Work experience

Total years of experience: 5 years, 4 months

CLAIM ANALYST

December 2021 - December 2024

CONDUENT Inc, BUSINESS OPERATIONS SOLUTIONS

Kerala, India

December 2021 - December 2024

• Processed over 500 insurance claims weekly, verifying member eligibility and medical documentation to enhance claim accuracy and minimize rejections.
• Leveraged expertise in medical coding (ICD-10, CPT), billing, and Revenue Cycle Management (RCM) to drive improvements in claim processing and reduce denials.
• Conducted thorough gap analysis and implemented automation strategies, resulting in a 10% reduction in claim rejection rates and a 15% decrease in processing time.
• Ensured strict compliance with HIPAA, CMS, and EDI 837/835 regulations in all claim submissions, maintaining high standards of data integrity and security.
• Developed strong communication skills to assist customers effectively, preparing for a transition into roles such as Medical Claims Processor and Customer Service Representative.
Company industry:
Business Consultancy Services
Job role:
Management

BUSINESS PROCESS EXECUTIVE

August 2020 - December 2021

AABASOFT BUSINESS SERVICE PVT.LTD

Kerala, India

August 2020 - December 2021

• Troubleshot and resolved network, hardware, software, and connectivity issues, ensuring seamless operations in medical claims processing.
• Delivered exceptional technical assistance and customer support through various channels, achieving high first-contact resolution rates.
• Leveraged CRM systems (Zendesk, Salesforce, Freshdesk) and ticketing platforms to efficiently document and manage customer interactions, enhancing service delivery.
• Analyzed Key Performance Indicators (KPIs) to drive improvements in service quality and process efficiency, contributing to overall business success.
• Developed strong communication skills to effectively engage with patients and clients, ensuring a positive experience in medical claims and customer service.
• Collaborated with cross-functional teams to streamline processes and enhance operational efficiency in a fast-paced environment.
Company industry:
Call Centers & Customer Care Outsourcing

DIGITAL MARKETING Intern

September 2019 - August 2020

Soften Technologies

Kerala, India

September 2019 - August 2020

• Developed and executed comprehensive digital marketing strategies, enhancing brand visibility and engagement.
• Conducted in-depth market research to identify trends and consumer preferences, improving targeting for campaigns.
• Managed various online marketing channels, including SEO, SEM, PPC, and Email Marketing, driving increased traffic and lead generation.
• Implemented On-Page and Off-Page SEO techniques, utilizing Google Search Console and analytics tools for performance tracking.
• Optimized paid media campaigns across platforms such as Google Ads and Meta Ads, achieving significant improvements in ROI.
• Leveraged analytical skills to inform data-driven decisions, ensuring effective communication and customer service in all interactions.
Company industry:
Software Development

Education

APJ Abdul Kalam Technological University

May 2019

May 2019

Bachelor's degree, Electric And Communication Engineering

India

GPA (percentage): 70%

GPA (percentage): 70%

Skills

Soft Skills

Expert

Administrative Support

Expert

Customer Relationship Management

Expert

Customer Support

Expert

Insurance Claims

Expert

ADJUDICATION

Intermediate

BUSINESS OPERATIONS

Intermediate

CLAIMS PROCESSING

Intermediate

COLLABORATION

Intermediate

COMPLEX PROBLEM SOLVING

Intermediate

CUSTOMER SERVICE

Intermediate

DOCUMENT PROCESSING

Intermediate

INSURANCE POLICIES

Intermediate

TELECOMMUNICATIONS ENGINEERING

Intermediate

Project management

Expert

Leadership

Expert

IT support

Expert

Problem solving

Expert

Creativity

Expert

Data Entry

Expert

Microsoft Excel

Expert

Customer Service

Expert

Receptionist

Expert

Front Office

Expert

Communications

Expert

Business Development

Expert

Administration

Expert

Microsoft Office

Expert

Ticket Management

Intermediate

SLA Monitoring

Intermediate

Service Request Handling

Intermediate

Application Support

Intermediate

Troubleshooting

Intermediate

First Contact Resolution (FCR)

Intermediate

Multichannel Support (Phone, Email, Chat)

Expert

Call Handling (Inbound & Outbound)

Expert

End-User Support & Query Resolution

Intermediate

Freshdesk (Ticketing & Support)

Expert

Zoho CRM

Expert

salesforce CRM

Expert

Exotel & Knowlarity (Telephony Systems)

Expert

Microsoft Excel (VLOOKUP, Pivot Tables)

Expert

Microsoft Office (Word, Excel, Outlook, PowerPoint)

Expert

Internal CRM

Expert

IT Technical Support

Intermediate

Helpdesk

Intermediate

Languages

English

Expert

Malayalam

Expert

Tamil

Native Speaker

Arabic

Intermediate

Memberships

Basics Telecom Technologies at Regional Telecom Center TVM

Trainer

June 2016

Training and Certifications

Training
Basic Telecom Technologies Regional
Telecom Training Centre, Trivandrum
Jun 2016