Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Himanshu Behl

Gurgaon

Summary

Efficient Senior Claims Processor known for high productivity and ability to complete tasks swiftly. Possess specialized skills in claims adjudication, regulatory compliance, and process improvement. Excel in critical thinking, problem-solving, and communication, ensuring smooth workflow and client satisfaction.

Overview

9
9
years of professional experience

Work History

Senior Claims Processor

NTT DATA
Gurgaon
01.2020 - Current
  • Ensured that all HIPAA privacy rules were followed when handling sensitive information.
  • Resolved complex claims issues requiring research and analysis of policy language, state laws, and industry standards.
  • Investigated customer complaints related to claim adjudication process or outcomes.
  • Identified discrepancies in claim information and requested additional documentation from providers.
  • Analyzed provider bills for accuracy, completeness, and conformance with established guidelines.
  • Maintained detailed records of all claims activity including payments made, denials issued, appeals filed.
  • Monitored changes in regulatory requirements impacting the claims payment process.
  • Evaluated the medical necessity of services provided by physicians, hospitals, and other healthcare providers.
  • Provided guidance to junior staff regarding claim processing procedures or technical issues.
  • Verified coverage eligibility for members through review of insurance contracts and benefit plans.

Senior Customer Service Associate

Concentrix Daksh India Pvt LTD
Gurgaon
09.2015 - 10.2017
  • Identified opportunities for process improvements within the customer service department.
  • Identified potential areas of improvement within customer service operations and communicated recommendations to management team.
  • Collaborated with management teams to develop strategies for improving customer service processes.
  • Utilized a variety of software applications to respond quickly to customer queries.
  • Assisted customers in navigating website features, enabling them to find products easily.
  • Reported any unresolved product issues or discrepancies to supervisor immediately.

Education

BCOM - Accounting And Finance

Delhi University
New Delhi
01-2012

High School Diploma -

SD Senior Secondary School
Gurgaon
02-2008

Skills

  • Process improvement techniques
  • Training and mentoring
  • Analytical Problem Solving
  • Critical thinking abilities
  • Claims review
  • Transactions reconciliation
  • Claim Amount Calculations
  • Problem-solving abilities

Languages

English
First Language
Punjabi
Proficient (C2)
C2
Hindi
Proficient (C2)
C2

Timeline

Senior Claims Processor

NTT DATA
01.2020 - Current

Senior Customer Service Associate

Concentrix Daksh India Pvt LTD
09.2015 - 10.2017

BCOM - Accounting And Finance

Delhi University

High School Diploma -

SD Senior Secondary School
Himanshu Behl