Vidhya Kr

Senior Quality Analyst with 4.3 years of experience in Healthcare Claims Adjudication and Quality Assurance, along with 1 year of experience in customer support. Proven expertise in claims processing and quality auditing, achieving 99% audit accuracy. Skilled in defect analysis, root cause analysis, and HIPAA compliance, with a strong focus on improving process quality and operational efficiency.

Senior Quality Reviewer at Cognizant Technology Solutions (2024-03 – 2026-03)

• Collaborated cross-functionally to drive process improvements and defect reduction initiatives.
• Improved team audit scores by providing actionable feedback and coaching
• Improved team performance by identifying error trends and implementing preventive actions
• Reduced defect leakage through effective prepay and prompt pay audit practices.
• Identified recurring errors using RCA, leading to measurable defect reduction at team level

Quality Reviewer at Cognizant Technology Solutions (2022-11 – 2024-03)

• Conducted quality audits on processed healthcare claims to ensure accuracy and compliance.
• Provided constructive feedback and coaching to claims processors to improve quality.
• Conducted defect analysis and Root Cause Analysis (RCA) to identify process gaps and error trends.
• Supported new joiners through training, reducing ramp-up time

Process Executive at Cognizant Technology Solutions (2022-01 – 2022-11)

• Processed healthcare claims adjudication to ensure accuracy and compliance
• Applied payer rules and policy guidelines to determine claim approval or denial
• Improved claim processing accuracy by effectively applying payer guidelines
• Reduced rework by ensuring high-quality claim validation

Customer Support Executive at KGISL Information Technology (2020-09 – 2021-11)

• Handled customer interactions through voice and chat support channels
• Resolved customer queries, complaints, and technical issues efficiently
• Improved customer satisfaction by resolving queries in first interaction (FCR)
• Reduced repeat issues by providing accurate and complete resolutions

BCA – Avinashilingam University (2017 – 2020)