BIMLESH KUMAR VERMA
TPA MANAGER
Gurgaon
Summary
Experienced TPA Manager specializing in insurance claims management and operational efficiency. Builds strong relationships with patients and resolves complex claim processing issues through effective negotiation and attention to detail. Focused on enhancing patient care services and streamlining processes for compliance and optimal claim settlements.
Overview
7
7
years of professional experience
1
1
Certification
3
3
Languages
Work History
TPA MANAGER
Park hospital
Gurgaon
05.2024 - Current
- Operational Management: Direct and do daily TPA operations, including scrutinizing, validating, and settling insurance claims efficiently.
- Managed daily TPA operations, scrutinizing, validating, and settling insurance claims to ensure prompt processing.
- Cashless & Billing Coordination: Do the entire process from patient admission to discharge, including pre-authorization, query, billing and final authorization.
- Coordinated cashless and billing processes from patient admission to discharge, including pre-authorization, billing, and final authorization.
- Data Reporting & Compliance: Analyze claims data, prepare MIS reports, and report to COO.
- Managed daily operations of patient care services in a busy hospital environment.
- Skills: Proficiency in TPA portals, medical billing software, and Microsoft Office, along with strong negotiation and communication abilities.
TPA MANAGER
Aarvy Hospital
Gurugram
01.2022 - 03.2024
- Operational Management: Direct and do daily TPA operations, including scrutinizing, validating, and settling insurance claims efficiently.
- Directed daily TPA operations, scrutinizing, validating, and settling insurance claims to ensure accuracy and timely processing.
- Cashless & Billing Coordination: Do the entire process from patient admission to discharge, including pre-authorization, query, billing and final authorization.
- Coordinated cashless process from patient admission to discharge, managing pre-authorization, queries, billing, and final authorization.
- Analyzed claims data and prepared MIS reports for COO to support informed decision-making and compliance monitoring.
- Managed daily operations of patient care services in a busy hospital environment.
- Skills: Proficiency in TPA portals, medical billing software, and Microsoft Office, along with strong negotiation and communication abilities.
INTERNSHIP STUDENT
Sethi hospital
Gurugram, IN
03.2019 - 09.2019
- Internship in tpa, reception and lab department
- Improved internship experience by efficiently managing assigned tasks and meeting deadlines.
- Gained practical experience in various aspects of the field, applying academic knowledge to real-world situations.
- Developed professional skills through hands-on experiences, including time management and effective communication.
Education
Master of Science - Chemistry
Dr. Rammanohar Lohia Avadh University
Ayodhya, Ambedkar Nagar Uttar Pradesh10-2022
Bachelor of Science - Biotechnology
Maharshi Dayanand University
Rohtak, Haryana10-2020
Higher Secondary School - undefined
Sarvodaya Bal Vidyalaya No-2
03-2015
School - undefined
Lord Krishna Convent School
Gurugram03-2013
Skills
TPA operations management
Insurance claims management
Claims processing software
Insurance financial analysis
Compliance reporting
Operational efficiency
Operations management
Time management
Customer relationship management
Team leadership
Certification
Robotics progrmer
Timeline
TPA MANAGER
Park hospital
05.2024 - Current
TPA MANAGER
Aarvy Hospital
01.2022 - 03.2024
INTERNSHIP STUDENT
Sethi hospital
03.2019 - 09.2019
Bachelor of Science - Biotechnology
Maharshi Dayanand University
Higher Secondary School - undefined
Sarvodaya Bal Vidyalaya No-2
School - undefined
Lord Krishna Convent School
Master of Science - Chemistry
Dr. Rammanohar Lohia Avadh University