BHARAT BHUSHAN
Bhilai
Summary
Accomplished professional with expertise in insurance fraud investigation at Gravity Integrates, leveraging strong communication and data analysis skills to deliver actionable insights. Proven track record in optimizing processes and enhancing compliance, resulting in a 20% reduction in fraudulent claims. Adept at leading cross-functional teams and driving strategic initiatives for impactful results.
Overview
15
15
years of professional experience
Work History
Health Insurance Claim Investigator
Gravity Integrates
Raipur
10.2023 - 10.2025
- Collecting and compiling data related to the investigation, including policy details, claim histories, medical records, and any relevant documentation.
- Reviewing and analysing the gathered information to identify discrepancies, inconsistencies, or potential fraudulent activities.
- Summarizing findings in a clear, concise, and objective manner. Reports should include details of the investigation process, findings, conclusions, and recommendations.
- Ensuring that all findings and conclusions are supported by evidence and documented accurately.
- Adhering to ethical standards, regulatory requirements, and company policies throughout the investigation and reporting process.
- Providing recommendations for action based on investigation findings, which may include policy adjustments, claims re-evaluation, or legal action.
- Conducted thorough investigations to identify compliance issues and gather evidence.
- Collaborated with cross-functional teams to develop investigative strategies and procedures.
- Analyzed data from various sources to support case findings and recommendations.
- Prepared detailed reports summarizing investigation results and insights for stakeholders.
- Utilized case management software to track investigations and document progress effectively.
- Communicated findings clearly to internal teams and external partners during briefings.
- Assisted in training junior investigators on best practices and methodologies in investigations.
- Maintained up-to-date knowledge of industry regulations and trends impacting investigations.
- Prepared detailed reports summarizing investigative activities and results.
- Organized and maintained files of all investigative activities.
- Adhered to departmental policies regarding investigations and reporting procedures.
- Reviewed police reports, medical records, and other documents for evidence.
- Researched relevant laws pertaining to active investigations.
- Presented case summaries at team meetings for review purposes.
Instructor
JAES Emergency Management Training Institute
Raipur
04.2022 - 10.2023
- Scheduling training programmes for EMTs & Pilot's, co-ordination with the district managers.
- Recruitment of EMT's & Pilots based on their basic knowledge of medicine and first aid.
- Preparing PPT for training, maintaining data of training programmes, and coordinating with HR to improve skill development of EMTs and Pilots.
- On job training of EMT's & Pilot's, and providing training in the field to improve the quality of work.
- Supervising hostel staff, including sanitation and other support staff.
- Participating in hostel committee meetings and contributing to policy decisions.
- Managing hostel operations, including maintenance and cleanliness.
- Conducting regular inspections of the hostel premises.
- Daily Reporting, Weekly Reporting.
- Team handling.
- Quality audits of ambulances to maintain the quality of our health service.
- Facilitated hands-on simulations to enhance participant engagement and learning outcomes.
- Collaborated with local agencies to align training with community safety needs.
- Evaluated training effectiveness through participant feedback and assessments.
- Created instructional materials to support various emergency response scenarios.
- Led workshops focused on emergency preparedness and response best practices.
- Maintained up-to-date knowledge of industry standards and regulations in emergency management training.
- Conducted lectures, demonstrations and group activities in order to enhance learning experience.
- Adapted teaching methods based on the physical, emotional and intellectual capabilities of students.
- Attended meetings, training and activities to enhance skills and credentials.
- Evaluated performance of students and made provisions to meet learning needs.
- Encouraged students' critical thinking skills by facilitating classroom discussions.
- Implemented instructional materials and curriculum to meet specific program needs.
- Planned instruction to achieve objectives based upon student needs and established curriculum.
- Developed guides and course materials to reinforce lecture information and help students learn.
- Created a positive learning environment by establishing open communication with students, parents and colleagues.
- Coordinated and facilitated training, encouraging group participation and ownership.
- Developed and delivered emergency management training programs for diverse audiences.
Instructor
GVK EMRI, Emergency Medicine Learning Centre
Raipur
08.2013 - 12.2019
- Scheduling training programs for EMTs and pilots, coordination with the district manager.
- SPOC of the PCR (Patient Care Record) Department: Ensuring all PCR and necessary documents for each case are received at the head office every month.
- QC of PCR and provided proper training on documentation according to government compliance.
- Maintain data on medicine supply and consumption according to the PCR record to reduce missed usage of medicine and achieve cost savings for the company.
- Recruitment of EMTs and pilots based on their basic knowledge of medicine and first aid.
- Preparing a PPT for training, maintaining data on training programs, and coordinating with HR to improve the skill development of EMTs and pilots.
- On-the-job training of EMTs and pilots, and providing training in the field to improve the quality of work.
- Preparing a monthly 'EM Care Magazine' for the selected best cases from all over CG, and giving nominations for awards at the state level and national level.
- Daily reporting, weekly reporting.
- Team handling.
- Quality audits of ambulances are conducted to maintain the quality of our health service.
- Developed and delivered emergency management training programs for diverse audiences.
- Created instructional materials to support various emergency response scenarios.
- Led workshops focused on emergency preparedness and response best practices.
- Provided mentorship to new instructors on curriculum delivery techniques.
- Attended meetings, training and activities to enhance skills and credentials.
- Provided individualized instruction to students to improve their academic performance.
EMT (Emergency Medical Technician)
GVK EMRI
Raipur
09.2010 - 08.2013
- Responded to emergency calls and assessed patient conditions promptly.
- Provided basic life support and advanced medical care during transport.
- Collaborated with healthcare teams to ensure effective patient handoff.
- Maintained equipment and supplies for readiness in emergency situations.
- Documented patient information (PCR) accurately for medical records and reporting.
- Participated in training sessions to enhance skills and improve response times.
- Maintained patient vital signs, including blood pressure, respiration rate, pulse rate, temperature, oxygen saturation level and pain levels.
- Performed basic life support procedures such as cardiopulmonary resuscitation and automated external defibrillation.
- Responded quickly to emergency calls, assessed the situation and provided appropriate treatment for illnesses or injuries.
- Demonstrated dedication to providing quality care through continued training and education.
- Documented patient assessment findings in accordance with established protocols.
- Assessed emergency situations and prioritized medical care for patients.
Pharmaceutical Engineer
ALKEM PHARMACUTICAL
Baddi
- Designed and implemented engineering solutions for pharmaceutical manufacturing processes.
- Collaborated with cross-functional teams to optimize product development timelines.
- Conducted thorough quality assurance testing on pharmaceutical products and equipment.
- Analyzed data to improve efficiency in production workflows and processes.
- Developed technical documentation for engineering projects and compliance standards.
- Assisted in troubleshooting equipment issues to minimize downtime in operations.
- Participated in safety audits to ensure adherence to regulatory requirements.
First Aid Trainer
St. John Ambulance (Red Cross Society)
- Developed and delivered first aid training programs for diverse audiences.
- Conducted hands-on practice sessions to enhance participant skills and confidence.
- Assessed learner performance through practical evaluations and feedback sessions.
- Collaborated with community organizations to promote first aid awareness initiatives.
- Updated training materials to reflect current best practices and safety standards.
- Facilitated workshops on emergency response techniques and life-saving procedures.
- Maintained training equipment and supplies for optimal instructional use.
Education
PGDFSDM - Fire safety and Disaster Management
Swami Vivekanand University
Sagar01.2019
PGDCA -
Dr. C.V. Raman
Raipur01.2016
B. Pharm -
B.P.U.T.
Raipur01.2009
Skills
- Good communication skills
- MS Excel
- MS Office
- MS Word
- MS PowerPoint presentation
- FAWIN
- Marg
- Basic Life Support (BLS)
- International Trauma Life Support (ITLS)
- Basic Life Support in Obstetrics (BLSO)
- Registered pharmacist at CSPC
- Investigation techniques
- Report writing
- Compliance auditing
- Data analysis
- Regulatory research
- Training coordination
- Quality assurance
- Emergency response
- Team leadership
- Problem solving
- Time management
- Report generation
- Risk analysis
- Insurance fraud
- Risk assessment
- Report preparation
- Research skills
- Interview coordination
- Insurance documentation
Languages
- Hindi
- English
Timeline
Health Insurance Claim Investigator
Gravity Integrates
10.2023 - 10.2025
Instructor
JAES Emergency Management Training Institute
04.2022 - 10.2023
Instructor
GVK EMRI, Emergency Medicine Learning Centre
08.2013 - 12.2019
EMT (Emergency Medical Technician)
GVK EMRI
09.2010 - 08.2013
Pharmaceutical Engineer
ALKEM PHARMACUTICAL
First Aid Trainer
St. John Ambulance (Red Cross Society)
PGDFSDM - Fire safety and Disaster Management
Swami Vivekanand University
PGDCA -
Dr. C.V. Raman
B. Pharm -
B.P.U.T.