Job Search Status
Open to workDesired Job Title
Junior Business AnalystData AnalystSubject Matter ExpertTeam LeaderWork Type
Full TimeLocation Preference
On-SiteHybridLocation: Hyderabad, IndiaPune, MH
Open to relocation: Yes
Open To Work
ABHISHEK SHINDE
Hyderabad
Work Preference
Summary
Dedicated and detail-oriented claims processor with 5+ years of experience. Strong expertise in U.S. health care systems, coding standards ICD, CPT, HCPCS and compliance requirements. Demonstrated ability in troubleshooting SQL-based data validation, and cross-functional collaboration to enhance system performance
Overview
4
4
Languages
1
1
Certification
7
7
years of professional experience
Work History
SENIOR ASSOCIATE CLAIMS
CARELON GLOBAL SOLUTIONS
09.2019 - Current
- Adjudicated US healthcare claims accurately, ensuring timely resolution and compliance with regulations.
- Processed appeals for IQT's ITS and non-ITS claims while maintaining accuracy in adjudication.
- Automated workflow from claim submission to disbursement, significantly reducing pending claims inventory.
- Managed real-time messaging process for timely resolution of client inquiries, ensuring compliance standards.
- Resolved general inquiries within defined turnaround time, improving client satisfaction and service efficiency.
- Facilitated claim adjustments and balance transfers due to insufficient insurance coverage, supporting financial accuracy.
- Collaborated with business analysts, QA, and external providers to streamline processes and validate solutions.
- Trained new associates while providing SME-level guidance and resolving escalated queries effectively.
Education
Bachelor of Commerce (B.com) -
Osmania University
Hyderabad 01-2019
XII standard -
Ratna Junior College
Hyderabad01-2015
Data Science - Data Analysis
Scaler School of Business And Tech
Bengalore 09-2026
Skills
- Data analysis
- Data cleansing
- Data manipulation
- Data visualization
- Reporting tools
- Database: Sql, Db2, MySql
- Data trend analysis
- Change management
- Time management
- Problem solving
- Mentoring team
- Teamwork
- Microsoft Excel
Personal Information
Date of Birth: 1998-06-09
DECLARATION:
I hereby declare that the above information furnished is true to the best of my knowledge. Abhishek Shinde
Languages
English
Advanced (C1)
C1
Marathi
Proficient (C2)
C2
Hindi
Native
Native
Telugu
Intermediate (B1)
B1
Certification
- SQL
Timeline
SENIOR ASSOCIATE CLAIMS
CARELON GLOBAL SOLUTIONS
09.2019 - Current
Bachelor of Commerce (B.com) -
Osmania University
XII standard -
Ratna Junior College
Data Science - Data Analysis
Scaler School of Business And Tech