Samitha M

B-704, SJR Spencer,

Varthur Main Road, Marathahalli Phone : 9986015673, 41155610
Bangalore-560037 Email : samitham@gmail.com

Experience Summary:

Over 10 years of experience working for various organisations viz., 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 and expertise in Pharmacy, Health and Worker’s
Compensation Claims management.
• Completed and successfully implemented the pharmacy process from
Minneapolis to Bangalore
• Completed the Process Mapping & migration plan for the Workers
Compensation Claims process to be migrated from San Diego to Bangalore. Worked in
San Diego for 7 months.

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.

• Discussing the Business Requirement with Business Team and authoring the
requirement work book for Rx – Processing 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 launch before 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 current status of preferred
generic products.
• Store Support: Responsible for researching, problem-solving and resolution
of product related issues.
• Trend Analysis: Analyze eform/update trends affecting drug cost, 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

• 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 ensure 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:

• Cambridge Solutions is one of the India’s business processes outsourcing

company with offices in US, Australia, India and UK. Cambridge provides
process consulting, financial and accounting services, transaction processing,
claim management and contact centre services for various financial services
sector viz., Banking, Mortgage and Insurance

Job Profile:

• 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
 • 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.

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.

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 cost-
effective 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.

Ajax.com (Medical Transcription) (1999 Sept to 2000 Sept.)

• Proofing of files from Proofer Level 1

 • Coordination of a group of M.L.S

Pfizer Ltd
Worked as Business Development Officer from 1998 Jan to 1999 Sept.

• Organize Seminars with Doctors

• Interview Doctors and collect data.