Open to opportunities

srikanth goud

@srikanthgoud

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Senior claims professional driving accuracy, compliance, and operational efficiency.

India

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What I'm looking for

I seek a role leveraging my Medicare claims adjudication and denial-management expertise in a compliance-focused, collaborative team that values process improvement and measurable accuracy gains.

I am a results-driven claims professional with over 10 years of experience in healthcare claims research, adjudication, and audit support. I combine deep knowledge of Medicare policies with hands-on adjudication to improve accuracy and reduce processing time.

At Genworth Financial I led efforts that reduced new-hire ramp-up time by 30% and achieved a 98%+ accuracy rate in claim closures, resolving 95% of NIGO cases within required timelines. I ensure strict compliance in claims documentation and support audit readiness.

During my tenure at Optum Global Solutions I resolved 95%+ of escalated Medicare claim issues, supported higher overturn rates on appeals through medical record verification, and improved provider relations through education and clear communication.

I am a proactive team player who mentors peers, provides floor support, and drives root-cause analysis to eliminate repeat errors. I seek opportunities where I can apply my expertise in claims adjudication, process improvement, and compliance to deliver measurable operational gains.

Experience

Work history, roles, and key accomplishments

Senior Claims Representative

Genworth Financial

Aug 2022 - Jul 2025 (2 years 11 months)

Streamlined onboarding reducing ramp-up time by 30% and resolved 95% of NIGO cases within timelines while maintaining a 98%+ claim closure accuracy and ensuring 100% compliance in documentation.

NIGO Resolution Audit Support Compliance Root Cause Analysis Onboarding Microsoft Office

Appeal Analyst

Optum Global Solutions

Feb 2019 - Aug 2022 (3 years 6 months)

Resolved 95%+ of escalated Medicare claim issues ensuring CMS compliance, increased appeal overturns via medical record verification, and reduced provider escalations through targeted education.

Appeals Medical Record Review Denial Management Provider Education Salesforce

Senior Claims Associate

Optum Global Solutions

Apr 2017 - Aug 2022 (5 years 4 months)

Resolved 95%+ of escalated Medicare issues, improved provider education to reduce repeat escalations, and supported appeals by verifying medical records to increase overturn rates while improving provider status verification turnaround by 20%.

Appeals Denial Management Salesforce CRM

Claims Associate

Optum Global Solutions

May 2015 - Mar 2017 (1 year 10 months)

Handled payment and adjudication of Medicare rework and corrected claims, performed claim adjustments and rekeys, audited associate work, and provided floor support and hospital adjudication training.