Summary
Overview
Work History
Education
Skills
Timeline
Generic
Ambuj Kumar Behera

Ambuj Kumar Behera

Pune

Summary

  • To pursue a career which aims at achieving targets successfully.
  • Exposure to different work culture
  • Taking challenges as well as opportunities for my career advancement in the industry.
  • Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency.
  • Uses independent decision-making skills and sound judgment to positively impact company success.
  • Proactive manager with demonstrated leadership abilities, strategic planning expertise and problem-solving acumen.
  • Assists senior managers with accomplishing demanding targets by encouraging staff and coordinating resources.
  • Methodical and well-organized in optimizing coverage to meet operational demands.

Overview

15
15
years of professional experience

Work History

Assistant Manager ,ERM

Wipro Technologies
04.2022 - Current
  • Initiating the internal audit for various projects aligned with ISO27001 standards.
  • Involved in Third party audit.
  • Successfully completion of SOC audits.
  • Ensuring the smooth flow of the audits.
  • Identifying the gaps in internal audits through root cause analysis.
  • Closure of internal audit by mitigating the risk through effective CAPA.
  • Identifying & highlighting risks of the projects through Account risk classification.
  • Understanding the clauses of contracts
  • Assessing the liability clauses of contracts.
  • Involved in deal risk review
  • Conducting transition audit to ensure smooth transition
  • Initiation, implementation and maintain of Business continuity Plan as per ISO22301-2019 guidelines
  • Coordinating for completion of successful SOC Audits
  • Monitoring Physical & logical reconciliation
  • Maintaining Account Risk register, Incident response plan & Data Visibility sheet as per ISO31000 guidelines.
  • Investigation the Security incident and preparing report for further action
  • Preparing system compliance tracker and sharing with client
  • Conducting Monthly connect with ops team
  • Assisting in PHI vault certification
  • Initiating BGV for new joiners and monthly BGV for all employees
  • Ensuring all the BGV parameters are met.

Mangement Trainee

AccessHealthcare
05.2017 - 04.2022
  • Transition Process
  • Creating SOP
  • Allocation
  • Process Improvement Plan
  • Feedback Tracker
  • Quality improvement plan
  • ISMS audits
  • Site compliance audits
  • Calibration with external and internal auditors
  • Initiating ATA process
  • Maintaining Quality Dashboard
  • Highlighting the process risk and site risk to management
  • NC reports
  • CAPA logs
  • Client Interaction
  • Weekly Report
  • Monthly Report
  • Quality Report
  • Insurance Payment analysis report
  • Payment Trend and collection Report
  • Creation and Maintaining Internal and External Dashboard
  • Monitoring the workflow.

Team Lead

Decipher India
04.2016 - 08.2016
  • Transition Process
  • Setting up Teams
  • Creating SOP
  • Allocation
  • PSB
  • Client Interaction
  • Weekly Report
  • Monthly Report
  • Production Report
  • Quality Report
  • Payment posting Report
  • Sales order Report
  • Insurance Payment analysis report
  • Payment Trend and collection Report
  • Account Receivable Aging Report
  • Creation and Maintaining Internal and External Dashboard
  • Monitoring the workflow
  • Training the staff on DME specialization
  • Supervising the staff on the denials
  • Making sure that the team target is met
  • Handling Team of 47 members.(17 day shift and 30 night shift)

Sr Analyst

Sysinformation Healthcare India Private Ltd
07.2014 - 01.2016
  • Analysis of the claim & Resolving the claim
  • Working on Denial management of Urgent Care
  • Training & supervising the team members
  • Weekly Report
  • Monitoring and assisting the team
  • Insurance Payment analysis report
  • Payment Trend and collection Report
  • Account Receivable Aging Report
  • Internal Quality Audit

Sr. AR Executive

Ansh Medical Services Private Ltd.
11.2010 - 04.2014
  • Working on Denial management
  • Patient collection & Attorney calling
  • Also working on settlement, Demand & Lien
  • Work for specialties like orthopedic, pshiotherapist, chiropractor
  • Mentoring and training up junior and new staff
  • Worked on Squal Med, Chartbase Softwares.

AR Executive

PORTECK India Info service Pvt. Ltd.
01.2010 - 09.2010
  • Working in ageing of Medicaid, Medicare & all commercial insurance as well
  • Also worked in worker's Compensation process
  • Worked on HP 1 & C4

Education

PGDBM -

NIMT
01.2009

B.H.M -

BANGALORE
01.2007

XII -

CHSE
01.2003

X -

I.C.S.E
01.2001

Skills

  • Certified ISO 27001 lead auditor
  • Certified in ISO31000
  • Certified in ISO22301
  • Certified lean green belt in Six Sigma
  • Involved in successful completion of SOC Audit for 2 consecutive years
  • Involved in successful completion of Third party audits of various projects
  • Deal Risk Review
  • Understanding the contracts of various projects
  • Identifying the limited clause in the contracts
  • Private Insurance collection
  • Worker Compensation
  • Appeals
  • Patient Calling
  • Edex
  • Filling Lien
  • AR follow up
  • Working on Demands and negotiating with Attorneys and Adjusters
  • Training

Timeline

Assistant Manager ,ERM

Wipro Technologies
04.2022 - Current

Mangement Trainee

AccessHealthcare
05.2017 - 04.2022

Team Lead

Decipher India
04.2016 - 08.2016

Sr Analyst

Sysinformation Healthcare India Private Ltd
07.2014 - 01.2016

Sr. AR Executive

Ansh Medical Services Private Ltd.
11.2010 - 04.2014

AR Executive

PORTECK India Info service Pvt. Ltd.
01.2010 - 09.2010

PGDBM -

NIMT

B.H.M -

BANGALORE

XII -

CHSE

X -

I.C.S.E

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Ambuj Kumar Behera