Darshan R
Bengaluru
Summary
Detail oriented Claims Operations professional with 2.5+ years of
experience in US healthcare claims processing, adjudication support,
and billing operations at Cognizant. Proven ability to manage SLAdriven
delivery, perform data validation, and resolve discrepancies with
high accuracy. Skilled in MS Office, claims lifecycle management, and
cross-functional coordination with onshore teams. Seeking to
contribute to high quality claims processing and operational excellence
in a dynamic environment.
Overview
3
3
Languages
5
5
years of professional experience
Work History
Senior Process Executive - Claims & Billing
Cognizant
Bengaluru
08.2021 - 03.2026
- Managed end-to-end US healthcare claims processing, ensuring adherence to SLA timelines, accuracy, and quality standards.
- Performed claims validation, adjudication support, discrepancy resolution, and inventory tracking of Pending/on-hold cases to ensure accurate payment processing and timely closure.
- Handled claims inventory management, tracking pended/on-hold cases and ensuring timely follow-ups for closure.
- Conducted data verification and reconciliation of claims and billing information in compliance with policy guidelines and audit requirements.
- Supported quality audits and error analysis, identifying root causes and contributing to process improvements.
- Ensured HIPAA compliance and data privacy standards while handling sensitive healthcare data.
- Ensured adherence to SLA, quality standards, and regulatory compliance
throughout the transaction lifecycle. - Assisted in process improvement initiatives to enhance productivity,
accuracy, and turnaround time.
Education
Bachelor of Science - Biotechnology, Chemistry And Microbiology
MS Ramaiah College of Arts Science And Commerce
Bengaluru01-2019
Class XII - PCMB
Sheshadripuram Composite PU College
Bengaluru01-2016
Class X - State Board
U.A.S. Campus School
Bengaluru01-2014
Skills
- Claims Processing
- Claims adjudication
- Claims Lifecycle Management
- Payment Validation & Billing Operations
- SLA & Productivity Management
- Discrepancy Resolution & Root Cause Analysis
- Quality Audit & Compliance (HIPAA)
- MS Excel (Data Tracking & Reporting)
Languages
English
Proficient (C2)
C2
Hindi
Proficient (C2)
C2
Kannada
Native
Native
Affiliations
- Dance
- Athletics
Timeline
Senior Process Executive - Claims & Billing
Cognizant
08.2021 - 03.2026
Bachelor of Science - Biotechnology, Chemistry And Microbiology
MS Ramaiah College of Arts Science And Commerce
Class XII - PCMB
Sheshadripuram Composite PU College
Class X - State Board
U.A.S. Campus School