Arindam Majumder
Kolkata
Summary
Claims Adjudicator with extensive experience in evaluating long-term care and mental health claims, ensuring compliance with policy guidelines and service level agreements. Revenue Cycle Manager skilled in implementing accounts receivable strategies to enhance cash flow and expedite reimbursement processes. Policy Compliance Expert proficient in conducting thorough policy analysis and documentation reviews to reduce fraud risks and maintain regulatory standards.
Overview
13
13
years of professional experience
Work History
Long-Term Care Claims Adjudicator
Genworth Financial India Pvt. Ltd.
07.2022 - 07.2025
- Claim Processing & Risk Handling: Process LTC claims, with a focus on complex credit handling, ensuring accurate payouts by thoroughly reviewing and interpreting policy terms and claimant data.nd claimant data.
- Policy & Documentation Review: Conduct detailed policy analyses to confirm claim eligibility and compliance, avoiding overpayments and ensuring adherence to SOPs and regulatory standards.
- Healthcare Coordination: Liaise directly with providers to verify billing and credit values, resolve discrepancies via phone and email, and expedite timely claim settlements.
- Compliance & Quality Assurance: Ensure compliance with healthcare policies and documentation standards, conducting data checks to maintain audit readiness and process integrity.
Senior Coding Analyst
Great Media Technologies Pvt. Ltd.
KOLKATA
11.2017 - 07.2022
- Coding and Claims Accuracy: Assigned and audited medical codes (ICD-10, CPT, HCPCS) for behavioral and mental health encounters, ensuring compliance with official guidelines, and accurate charge capture.
- Revenue Cycle & AR Management: Managed insurance collections and accounts receivable, including AR follow-up calls and claims submissions, to support timely reimbursements.
- Training & Mentorship: Provided on-floor support and training to coding staff, conducted continuous coaching sessions, and addressed audit findings to improve coding accuracy and team performance.
- Workflow Coordination: Oversaw coding and claims submission processes, scheduled patient appointments, managed clinicians' calendars, and facilitated prescription refills to ensure smooth operations.
Senior Executive
AEGIS Limited (Aegis Health)
KOLKATA
04.2014 - 08.2016
- Audited HVAC (US Home Improvement Project)
- Supervised a team of six in the U.S. healthcare vertical, assigning tasks, monitoring performance, and ensuring alignment with operational goals.
- Performance Reporting & Analysis: Prepared and analyzed daily, weekly, and monthly performance reports to track productivity trends, and support data-driven decision-making.
- Productivity & Quality Oversight: Monitored team productivity and enforced quality benchmarks to maintain high service standards and operational excellence.
- Compliance Audits & Communications: Managed operational emails and conducted voice audits to ensure adherence to internal policies and regulatory compliance.
- Process Improvement & Automation: Developed Excel-based templates for productivity tracking and break monitoring, streamlining workflows and enhancing team efficiency.
Executive - Operations
AEGIS Limited
KOLKATA
08.2012 - 07.2013
- Technical Support & Installation: Provided SME-level technical assistance for Tata Photon services, guiding customers through dongle installation and troubleshooting to ensure seamless connectivity.
- Customer Billing & Communication: Generated and explained billing statements to clients, clarifying charges and resolving queries to enhance satisfaction.
- Shift Leadership & Operations: Mentored the nightshift operations team, managing workflows and maintaining service efficiency across off-peak hours.
Education
Bachelor of Computer Application -
Institute of Management Study
Kolkata, WBUT, India12.2011
Skills
- Claims Adjudication & Processing
- Insurance Collections & AR Follow-up
- Healthcare Policy Interpretation
- Medical Coding
- Discrepancy Resolution
- Technical Troubleshooting
- Team Supervision & Performance Monitoring
- Compliance & Quality Assurance
- Process Improvement
- Patient Scheduling & Calendar Management
- Operational Reporting
- Voice & Email Audit Management
- Training & On-floor Support
- Client Communication & Billing Support
- Multi-platform Coordination
Professional Degrees And Accreditations
- Bachelor of Computer Application (BCA), Institute of Management Study, Kolkata - WBUT, 2011, Kolkata, West Bengal
- AAPC Certified Coder - Behavioral Health
<Enter your own>
Title: LONG-TERM CARE CLAIMS PROCESSOR
Awards
- Best Employee of the Month, 2
- Star Performer - Quality of the Month, 1
Timeline
Long-Term Care Claims Adjudicator
Genworth Financial India Pvt. Ltd.
07.2022 - 07.2025
Senior Coding Analyst
Great Media Technologies Pvt. Ltd.
11.2017 - 07.2022
Senior Executive
AEGIS Limited (Aegis Health)
04.2014 - 08.2016
Executive - Operations
AEGIS Limited
08.2012 - 07.2013
Bachelor of Computer Application -
Institute of Management Study
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