Sumesh Rajan

Oracle CRM Lead Consultant:
• Allocating jobs and workloads to team members based on their ability.
• Providing accurate updates to the team based on weekly stakeholder call.
• Giving prompt and accurate information on each team members performance.
• Establishing team and staff target as a reflection of the company's object.
• Providing accurate information to management on key issues.
• Managing 6 FTE's.
• Working on implementation, upgrades, enhancements and support projects in Salesforce.
• Maintaining objects, fields, Record Types, workflows, approvals processes, Escalation rules, Assignment rules validation rules, data migration activities, custom page layouts, custom fields, cases management and other standard functionalities.
• Managing and implementing changes in lead flow process across various system. Coordinating with multiple stakeholders across different teams to facilitate implementation of theses changes.
• Worked on various CRM standard objects like Accounts, Contacts, Leads, Campaigns, Opportunities.
• Supports the Bid process in preparing and deploying the bid plan.
• Reporting with Oracle CRM.
• Closely worked with SalesForce.com consultants while implementing the solutions for the requirements.
• Designed, Implemented and deployed the Custom objects, Page layouts, Custom tabs, and Components, to suit the needs of the application.
• Involved in Oracle CRM application setup activities and customized the apps to match the functional needs of the organization.
• Knowledge on Mass Transfers, data loads, data validation process.

 Senior Analyst: 
 Reporting and Dashboard creation on Salesforce. 
• Coordinate with business unit leaders, particularly marketing liaisons and billing centers for Salesforce onboarding and administration requirements. 
• Performing secondary researches in Hoover’s or D&B for identifying the company’s hierarchy (whether a company is Parent, Subsidiary, etc).
• Handling the Salesforce data management Case queue. 
• Responsible to perform the validation check of Company related information. 
• Worked on verification, rule-based and decision based environment. 
• Managed the Salesforce Users. 
• Having Knowledge on Excel, Macros, CRM concepts, Dashboards, Data Analytics and Analysis. 
• Experience in explaining the findings to clients and stakeholders over a video/voice call. 
• Having Knowledge on business requirements and in coordinating with business unit leaders particularly marketing liaisons for reports/data. 

• Adjudication of US health care claims, Medicare, HMO’s and PPO’s. 
• Assigning correct benefits and arriving at accurate coordinated benefits between the insurance provider and patient. 
• Applying member benefits between copay, coinsurance & deductible 
• Financial recovery in terms of overpayment.
• Coordinating the claims with appropriate EOB/EOMB as per COB investigation. 
• Maintaining quality parameters as procedural and financial with 100%.
• Assisting team members in clearing up tough and old claims from route databases. 
• Monitoring the quality levels and implementing the corrective and preventive action plans for meeting and exceeding client quality standards (SLA).