Satyanarayan Panigrahy

Lead the Lien Operations team, managing medical tort record audits, agency correspondence, Conditional Payment Letter (CPL) requests, dispute letters, and Medicare lien compliance while ensuring SLA adherence. Drive process improvement and automation initiatives by identifying efficiency opportunities and standardizing workflows.

Led a team of 53 associates, consistently achieving productivity, quality, and SLA targets through effective workforce planning and performance management. Led a dedicated team supporting Pharmacy Benefit Management (PBM) accounts, overseeing claims processing, quality, and SLA performance for PBM operations.

Led a team of 30 associates supporting pre-pay and post-pay healthcare claims operations while consistently achieving production, quality, and SLA targets. Improved quality performance from 92% to 99% through structured coaching, quality initiatives, and continuous performance management.

Developed and implemented IBM Operational Decision Manager (ODM) rules using SQL to automate business processes and improve operational efficiency. Analysed operational data and translated business requirements into rule logic for deployment and system enhancement.

Conducted medical claims audits to ensure compliance with client guidelines, CMS requirements, and internal quality standards. Prepared quality dashboards, MIS reports, KPI analysis, and management presentations.

Adjudicated Medicare, Medicaid, and Commercial healthcare claims while ensuring compliance with payer policies and CMS guidelines. Processed Prior Authorization, Timely Filing, Referral, DME, Ambulance, Skilled Nursing, and Anesthesia claims with high accuracy and productivity.

Bachelor of Science in Chemistry Honours from Berhampur University, completed in 2016.