kousalya v
@kousalyav
Claims associate specializing in US PPO credentialing and provider enrollment processes.
What I'm looking for
I am a Claims Associate with over 11 years of experience focused on PPO claims and credentialing for US healthcare providers. I manage end-to-end credentialing, ensuring providers are added to network codes and all documentation is collected and verified.
At Guardian India Operations Pvt Ltd, I oversaw credentialing workflows, verified licenses, certifications, education, work history and references, and maintained compliance with client requirements and state laws. I have strong experience with CAQH, Cactus, and PPO enrollment processes.
Previously, I worked as a Junior Associate at HDB Financial Services, where I validated customer demographics, KYC documents, PAN/Form 60, credit histories, and performed contact point verifications to support lending processes.
I hold an MS/M.Sc in Computers and a BCA from Bharathidasan University, with a track record of maintaining process TATs and facilitating smooth provider integrations across multiple US states.
Experience
Work history, roles, and key accomplishments
Claims Associate
Guardian India Operations Pvt Ltd
Jan 2017 - Aug 2025 (8 years 7 months)
Managed end-to-end credentialing and PPO claims processes for US healthcare providers, reducing application delays by enforcing TAT and ensuring compliance with state rules and client policies.
Junior Associate
HDB Financial Services
Jun 2014 - Dec 2016 (2 years 6 months)
Screened and validated customer applications and KYC documents, performed signature and CPV checks, and assessed credit history via CIBIL to support compliant loan processing.
Education
Degrees, certifications, and relevant coursework
Bharathidasan University
Master of Science, Computers
2011 - 2013
Grade: 84%
Completed Master of Science in Computers with 84% grade from Bharathidasan University, Trichy.
Bharathidasan University
Bachelor of Computer Applications, Computers
2008 - 2011
Grade: 86%
Completed Bachelor of Computer Applications in Computers with 86% grade from Bharathidasan University, Trichy.
Availability
Location
Authorized to work in
Job categories
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