DIPAK GONATE
Bhukum
Summary
Experienced Insurance Operations Specialist with over 5 years of expertise in claims management, customer support, and office administration. Skilled in Excel, SQL, and Power BI for data-driven decision-making.
Overview
6
6
years of professional experience
Work History
Team Lead
Vidal Health Insurance TPA Pvt Ltd
05.2022 - Current
- Managed claim intimation, policy enrollment, and TPA ID generation to streamline processes.
- Verified claims documents to ensure accuracy and compliance.
- Checked daily MIS and assigned pending cases to DR and backend teams for timely resolution.
- Attended corporate and retail helpdesk to provide assistance and support.
- Monitored and responded to all incoming and outgoing emails for clear communication.
- Visited National Insurance and United Insurance Branch offices for help desk support.
- Conducted data reconciliation, payment error resolution, and approval processes at RO offices.
- Maintained Outstanding Dump, monitored pending cases, and expedited resolution efforts.
Claim Specialist
Cloud Nine Hospital
01.2021 - 04.2024
- Handled patient queries regarding insurance procedures and coordinated from admission to discharge.
- Processed cashless insurance claims efficiently.
- Coordinate with insurance teams for estimation, approvals, and faster claim settlements.
- Support patients throughout the Mediclaim journey, ensuring smooth service.
- Ensured seamless Mediclaim journeys and high customer satisfaction.
Operation Executive
Vipul Medcorp Pvt Ltd
06.2019 - 01.2021
- Addressed patient and agent queries related to insurance services.
- Managed claim intimation, policy enrollment, and TPA ID generation.
- Handled calls and emails for IC approvals, delayed submissions, and documentation.
- Ensured compliance with TAT and maintained detailed records.
- Verified and assisted insured members with claims document submission.
- Visited PSU insurance offices and corporates for helpdesk support.
- Generated and dispatched policy ID cards.
- Maintained outstanding claims data via MIS for follow-ups and resolution.
Education
MASTER OF BUSINESS ADMINISTRATION (MBA) -
Dr D.Y. Patil Vidyapeeth
Pune09.2024
BACHELOR OF COMPUTER APPLICATION -
Raja Shree Shivray Pratishthan College of Science & Commerce
Pune09.2020
Skills
- Microsoft Excel and SQL
- Insurance claims processing
- Team leadership
- Customer service
- Python programming
- Power BI visualisation
- Problem solving
- Communication skills
- Critical thinking
- Time management
- Attention to detail
- Adaptability
- Team collaboration
Personal Information
Father's name: Sanjay Bhiva Gonte
Date of birth: 02/23/1997
Marital status: unmarried
Gender: Male
Religion: Hindu
Nationality: Indian
Accomplishments
- Received the Employee of the Month award twice at Vidal and twice at Claimtherapist.
Languages
Marathi
First Language
Hindi
Intermediate (B1)
B1
English
Intermediate (B1)
B1
Timeline
Team Lead
Vidal Health Insurance TPA Pvt Ltd
05.2022 - Current
Claim Specialist
Cloud Nine Hospital
01.2021 - 04.2024
Operation Executive
Vipul Medcorp Pvt Ltd
06.2019 - 01.2021
MASTER OF BUSINESS ADMINISTRATION (MBA) -
Dr D.Y. Patil Vidyapeeth
BACHELOR OF COMPUTER APPLICATION -
Raja Shree Shivray Pratishthan College of Science & Commerce
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