Lawrence Xavier

Experience

• 

  InterPro Global

  Feb 2012 - Apr 2012

  Intern

  3 Months Internship Program - College project

• 

  Cognizant

  Jun 2012 - Apr 2022

  1. Analyzing BRD, creating Test Cases and Test Execution 2. Involved in Writing and executing functional, integration and System Test cases, reviewing test cases, performing smoke, regression, Testing and identifying the issues, create, track and report the issues and triaging with Dev/SME/BA team. 3. Requirement traceability compliance tracking in ALM4. Involved in Defect tracking and Analysis in terms of Logging and Review of defects in ALM.5. Preparing status reports/Metrics for test execution - status summary, test estimations, test strategies.6. Involved in - LOB wise testing in Facets application, Test scenarios and Test cases designs, EDI file preparation and all Acknowledgement for 837 Transactions. End-to-End process flow like Initial Member creation until EOB and RA. Claims Payment 835 transactions, EOB and RA extract, and Image validations. Show less 1. Experience in US Healthcare Industry – Claims adjudication & Supporting for UAT execution (Provider & Payer) 2. Rich Experience in Medical Billing Concepts, Payment and Provider data Management contracts, Claim Adjudication of both Manual and Auto Adjudication. 3. Experienced in End to end processes Knowledge of Adjudication and Provider contracts. Good analyze of HCFA & UB claims. 4. Ensure proper quality control to meet and exceed expectations of client SLA. 5. Conducting daily team meeting to discuss on the quality of the claims 6. Auditing the claims and providing feedback to the examiners 7. Root cause analysis on the error claims to improve the quality 8. Connecting with each examiners to improve the quality 9. To have frequency Offshore-Onsite Communication with the Team Leaders/Managers to report the Status of the team performance on a weekly basis. 10. Updating team accuracy scores and makes the team to achieve the mentioned accuracy in all 3 grounds (procedural, financial & payment) and conducting training programs for new comers and refresh training to existing team members, when required. 11. Handling the Team pend reports and resolving them in given time 12. Auto Adjudication Analysis & Improvement. 13. Client Interaction on daily basis Show less

  • Associate

    Feb 2017 - Apr 2022

  • Process Specialist

    Feb 2015 - Jan 2017

  • Senior Process Executive

    Feb 2014 - Jan 2015

  • Process Executive

    Jun 2012 - Jan 2014
• 

  HCL Technologies

  May 2022 - Mar 2023

  Business Analyst

  Business Analyst

• 

  Thryve Digital Health LLP

  Mar 2023 - now

  Senior Consultant