Keval Parmar profile photo 1 on Tal

Keval Parmar

Team leader- US Healthcare

Mumbai

11+ years of work experience

Hexaware Technologies
Feb 20242 yrs 4 mosPresent

Navi Mumbai, Maharashtra, India

Hexaware Technologies
Feb 20242 yrs 4 mosPresent

Lead a blended operations team (Voice, Email, Backend) delivering Eligibility services for ~550 clients covering ~700,000 member lives, ensuring adherence to SLAs including internal quality, external quality, and TAT. Spearheaded transition and stabilization of the Electronic Eligibility process, enabling seamless onboarding and operational readiness. Manage a team of 30 (25 Operations + 5 QA), driving productivity, performance management, and continuous quality improvement. Reduced client escalations by 70% through proactive issue identification, root cause analysis, and process optimization. Oversee end-to-end EDI 834 processing (enrollment, maintenance, audits), ensuring high accuracy and compliance standards. Act as primary client contact, managing governance calls, escalations, and critical requests while strengthening stakeholder relationships. Drive SLA performance across internal quality, external quality, and turnaround time (TAT), ensuring consistent service delivery excellence. Collaborate with cross-functional teams to implement process improvements and enhance operational efficiency.
Wipro
Jul 20158 yrs 7 mosJan 2024

Mumbai, Maharashtra, India

WIPRO BPO LTD
Jul 20207 mosJan 2021

Analyzed and adjudicated claims for payment and denial decisions, ensuring strict adherence to medical policies, compliance guidelines, and accuracy standards. Selected for a high-impact E2E transformation project, driving cross-queue optimization and TAT reduction through streamlined workflows. Resolved complex member/provider appeals, fraud & abuse cases, and pharmacy disputes, ensuring timely and compliant resolution of critical issues. Handled NICE queue adjudication, validating ICES edits and finalizing claims with high accuracy and minimal rework. Served as Subject Matter Expert (SME) for OON Disputes, leading payment negotiations with out-of-network providers, and driving research, audits, and knowledge transfer initiatives. Supported and audited OON dispute cases, ensuring resolution accuracy, compliance adherence, and continuous quality improvement.
Venkatesha Realty
20123 yrs2015

Managed financial accounts for real estate projects, including contractor payments, customer receipts, and account reconciliation. Supported sales and operational teams with financial reporting and performance tracking. Maintained accurate financial documentation and ensured smooth coordination between accounts and operations teams.

Education

University of Mumbai

Bachelor's degree, Information Technology

University of Mumbai

Join Keval and 10k+ other professionals on

Tal Boss

Tal is the app where bosses meet engineers & builders directly, without middlemen

Download Tal Boss

Keval Parmar on Tal

Headline

Team leader- US Healthcare

About

Results-driven team leader with 9.5 years of experience in the U.S. healthcare industry, specializing in fostering collaboration and driving high-performance teams. Adept at coordinating efforts across diverse departments to enhance patient care and streamline operations. Proficient in implementing process improvements and leveraging data analytics to identify opportunities for growth and efficiency. Strong communicator with a passion for mentoring team members and cultivating a positive work environment that encourages innovation and accountability. Seeking to connect with other professionals to share insights and drive impactful change in the industry.

Location

Mumbai

Work experience

Team Lead at Hexaware Technologies, Feb 2024 - Present · 2 yrs 4 mos, Navi Mumbai, Maharashtra, India

Clinic Manager at Hexaware Technologies, Feb 2024 - Present · 2 yrs 4 mos, Lead a blended operations team (Voice, Email, Backend) delivering Eligibility services for ~550 clients covering ~700,000 member lives, ensuring adherence to SLAs including internal quality, external quality, and TAT. Spearheaded transition and stabilization of the Electronic Eligibility process, enabling seamless onboarding and operational readiness. Manage a team of 30 (25 Operations + 5 QA), driving productivity, performance management, and continuous quality improvement. Reduced client escalations by 70% through proactive issue identification, root cause analysis, and process optimization. Oversee end-to-end EDI 834 processing (enrollment, maintenance, audits), ensuring high accuracy and compliance standards. Act as primary client contact, managing governance calls, escalations, and critical requests while strengthening stakeholder relationships. Drive SLA performance across internal quality, external quality, and turnaround time (TAT), ensuring consistent service delivery excellence. Collaborate with cross-functional teams to implement process improvements and enhance operational efficiency.

Team Lead at Wipro, Jul 2015 - Jan 2024 · 8 yrs 7 mos, Mumbai, Maharashtra, India

Claims Specialist at WIPRO BPO LTD, Jul 2020 - Jan 2021 · 7 mos, Analyzed and adjudicated claims for payment and denial decisions, ensuring strict adherence to medical policies, compliance guidelines, and accuracy standards. Selected for a high-impact E2E transformation project, driving cross-queue optimization and TAT reduction through streamlined workflows. Resolved complex member/provider appeals, fraud & abuse cases, and pharmacy disputes, ensuring timely and compliant resolution of critical issues. Handled NICE queue adjudication, validating ICES edits and finalizing claims with high accuracy and minimal rework. Served as Subject Matter Expert (SME) for OON Disputes, leading payment negotiations with out-of-network providers, and driving research, audits, and knowledge transfer initiatives. Supported and audited OON dispute cases, ensuring resolution accuracy, compliance adherence, and continuous quality improvement.

Account Executive at Venkatesha Realty, 2012 - 2015 · 3 yrs, Managed financial accounts for real estate projects, including contractor payments, customer receipts, and account reconciliation. Supported sales and operational teams with financial reporting and performance tracking. Maintained accurate financial documentation and ensured smooth coordination between accounts and operations teams.

Education

Bachelor's degree, Information Technology, University of Mumbai