Saloni Sethi

Professional Summary Address

Competent and consummate professional. Overall, 11 Years of experience
out of which having 9+ years of experience in US Healthcare Insurance ssaloni.sethi@gmail.com
( Medical billing ,claims adjudication,Clinical data abstraction related to +91-9910549705
Oncology patients, Medical tagging and abstraction for Supplemental Flat no. 7, 2nd floor, Lane no .1, near
health insurance, Utilization management review ,Revenue cycle Ashok plaza, Nam Dev Nagar,
management, Medical Summarization ),spanned across various roles in Wadgaonsheri, Pune - 411014
Operations, Quality & Process excellence and Training Delivery.

Skills
Work History
● US healthcare (payer and provider side)
Genpact India pvt Ltd -Service delivery manager ● Preparing reports and dashboards
Pune,Maharashtra ● EDT,HL7,HIPAA,EMR and EHR
01/2022-Present ● Customer satisfaction
Currently working as delivery manager and handling US insurance client ● Change management/ Project
for North America region . management/ Business continuity
management
Stakeholder management, Managing SLA delivery , Business process ● Performance/Client
management, client relationship management, process improvement, New management/Transition management
business transition, Lean six sigma methodology used to improve business ● Project management, Agile
process with help of IT deployment projects in collaboration with Lean methodology
digital transformation and Robotic process automation team. ● Presentation skills, Communication
skills, Analytical Skills, Problem Solving
Have experience in leading projects End to End using lean six sigma and Skills, Conflict resolution
Agile methodology .Knowledge about EDT,HIPAA,HL7 US healthcare ● Computer competencies
Payer and provider side ,Revenue cycle manager, core US healthcare
knowledge

Leading transformation projects with DTS team(Digital transformation) Certifications

Doing the due diligence, good analytical skills, agile projects.
● Insurance Domain – Certified from The
Institutes, USA for INTRO 320 in
Develop thought leadership and support transformation. Have also
Property and Causality Insurance
supported few projects in BFSI sector
● Six Sigma – Green belt Six sigma
certified
Good in change management and transforming business through digital
● AI online course by Coursera - Worked
solutions
with transformation team in RPA in
solution designing for identified
opportunities
EXL Services Pvt.- Lead Assistant Manager
Pune, Maharashtra Education
03/2014 -01/2022
2006-2010
06/2019- 01/2022: Lead Assistant Manager BRS Dental College
Panchkula, Punjab
● Managing operations- Team span of 50+ executives, dotted line
BDS
reporting and 2 Assistant Managers line reporting for US
One year rotatory internship- 2010-2011
healthcare insurance account collaborating with one of leading
Healthcare Insurance company in California region
● E2E utilization management review, prior authorization, 2005
precertification, predetermination, HIPAA compliance, sound St. Theresa’s Convent School
knowledge of Medicare, Medicaid Karnal, Haryana
High School- Science
● Worked on EMR like faxes, portals etc .
C.B.S.E.
● Proficiently handling service delivery operations and implement
strategies for ensuring client satisfaction, business growth and
expansion
● Drive process improvement in coalition with Process Excellence
team. Evaluate, quantify, sign-off and implement quick wins
● Identifying Risk opportunities in the process
● Leading process improvement projects within the process
● Escalations Management- Client Management- People
Management
● Co-working with automation team
● Responsible for meeting key deliverables of the process
● Recruiting, training and development of new hires.
● Identify and mitigate any risks/issues that are foreseen as potential
bottlenecks to the process
● Ensure compliance with internal policies and procedures, external
regulations, and information security standards

12/2016- 06/2019: Assistant Manager (Noida, Uttar Pradesh)

● Managed Operations of Insurance P&C process- client renewal
support engagement
● 35 FTEs line reporting
● Performance management, SLA improvement, People
Management, Inventory management
● Provide coaching and feedback to team members to enable them to
improve performance and ensure all client metrics meet defined SLA
● Design a learning path according to individual needs for
executives and senior executives and get them trained as per the
program
● Preparing various operational and quality dashboards for internal
and external stakeholders and interact through weekly,
fortnightly, and monthly calls with client and business associates
onshore
● Achieve KPIs, quantitative & qualitative targets
● Escalations Management- Client Management
12/2015- 12/2016: Quality Compliance Analyst
● Monitor transactions and give feedback. Work allocation and
tracking
● Take update sessions, refresher sessions and help in training of
new batches
● Displayed exceptional stakeholder management skills by actively
coordinating between frontline Operations leadership and QCA
team which led to numerous appreciations from internal and
external customers

03/2014- 11/2015: Medical Summarizer (LPO), Senior Executive

● Sorting and summarization of medical records for claim
adjudication
● Reconciliation of medical bills of plaintiff/claimant
● In-process review of summaries sent to Legal Field Offices

Dental Clinic experience

Worked from Dec 2011 to Dec 2013 as Dentist in different clinics and
performed dental procedures and treatment on patients

Accomplishments

● Collaborated with WFM and Process Excellence to automate the daily

production tracker for the Team which lead to RE Improvement
● Handled process optimization ( Hackathon, AIM )and automation
projects(Onekey project and INT Track tool ) which has helped EXL to
increase efficiency, accuracy and reduce cost
● Lead a Project with Collaboration with PE team to implement automation
to one of the Application which lead to AHT reduction and increase
efficiency for the Team.
● Responsible for BOT implementation in CRS Insurance process in
collaboration with Technology team.
● Lead 2 migrations successfully- 15 FTEs and 50+ FTEs- EXL
Services Pvt.td. - Closely worked with EXL transition team in two
of the migrations at India and have worked in closely coordination
with migration managers and have good amount of knowledge in
migration of new business and clients.
● Received Super Captain Award in the year 2020 - EXL Services Pvt
Ltd.
● Received best AM and best Team award in the year 2017- EXL
Services Pvt. Ltd.
● Received Rising Star, Extra Miler and Star Performer in year 2014
and 2016 - EXL Services Pvt.td.
● Earned a star certificate for getting lean ideas implemented in
project
● Recently led an green belt six sigma project for process
improvement
.