GAURAV MALIK
Faridabad
Summary
Highly motivated and detail-oriented Data Analyst with 1.5 years of experience in the healthcare insurance sector. Proficient in analyzing complex datasets, coding benefits, and ensuring compliance with regulatory requirements. Skilled in Excel, FACETS, PEGA, Knowledge Exchange, and B&C Legislation Tool. Currently completing MBA from MDU University to enhance strategic and business management expertise.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Data Analyst (Health Insurance)
Concentrix Daksh Limited
Gurgaon
02.2024 - Current
- Process and analyze customer insurance data from CIT (Customer Information Template), covering health, pharmacy, dental, and vision plans.
- Handle multiple plan types: ASO, Fully Insured, ERISA, Non-ERISA, SureFit, OAP, OAPIN (network-only), and HSA plans for new business, renewals, and amendments.
- Configure and code benefits in FACETS and PEGA applications, ensuring accurate setup of deductibles, out-of-pocket limits, and plan rules.
- Code Essential Health Benefits (EHBs) such as preventive care, acupuncture, physical/occupational therapy, TMJ, etc., including visit limits and state-specific requirements.
- Maintain plan-specific prefixes and SEPY codes in Excel to support in-network, out-of-network, and out-of-area benefit configurations.
- Use Knowledge Exchange platform to access updates on new benefits and regulatory changes.
- For Fully Insured plans, apply B&C Legislation Tool to ensure compliance with mandates and state laws.
- Ensured accuracy and compliance in benefit coding, reducing claim errors and improving operational efficiency.
- Successfully processed and coded 100+ healthcare plans with high accuracy.
- Reduced claim discrepancies by 15% through precise coding and data validation.
- Improved reporting efficiency by 20% using structured Excel trackers for prefixes and SEPY codes.
- Ensured 100% compliance with state mandates and client requirements.
Education
MBA - Finance
MDU University
ROHTAK08-2025
BBA - General
Echelon Institute of Technology, JC Bose University
01.2023
Sr. Secondary -
KMP Sr. Sec. School
01.2020
Matric -
KMP Sr. Sec. School
01.2018
Skills
- Data Analysis & Reporting
- Microsoft Excel & Office Suite
- FACETS & PEGA Applications
- Business Acumen & Problem-Solving
- Collaboration and communication
- Adaptive and Quick Learner
- Effective communication
Hobbies and Interests
- Watching Movies
- Surfing Internet
- Creativity
- Learning
- Gym
Certifications Courses
- Fundamentals of Digital Marketing – Google
- Appreciation of Digital Literacy – NIOS
- Training and Development – NPTEL
- Energy Literacy – Swaraj Foundation
Languages
Hindi
First Language
English
Upper Intermediate (B2)
B2
Certification
- Fundamentals of digital marketing (by google).
- Appreciation of digital literacy (by NIOS)
- Training and Development (by NPTEL).
Timeline
Data Analyst (Health Insurance)
Concentrix Daksh Limited
02.2024 - Current
MBA - Finance
MDU University
BBA - General
Echelon Institute of Technology, JC Bose University
Sr. Secondary -
KMP Sr. Sec. School
Matric -
KMP Sr. Sec. School
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