HIMESH PIPRIYEA
Hyderabad
Overview
4
4
years of professional experience
Work History
Claims Associate
Optum Global Solution
10.2020 - 01.2025
- Detail-oriented and results-driven Claims Representative with 4 years of experience in processing and resolving a wide range of insurance claims. Skilled in policy analysis, investigation, and customer service with a strong track record of ensuring fair settlements and compliance with regulatory standards. Adept at managing high-volume workloads, handling complex cases, and collaborating effectively with clients, adjusters.
Claims Representative
Optum global solution
Hyderabad
10.2020 - 01.2025
- Analyzed high-volume COVID-related claims to distinguish between COVID-specific and general claims.
- Processed claim adjustments with precision and adherence to guidelines.
- Managed Authorization and Power of Attorney forms effectively.
- Executed denial management strategies to resolve issues efficiently.
- Administered refunds from payers and providers with accuracy.
- Updated member contact information based on system reports promptly.
- Cleared inventory within defined thresholds and turnaround times.
- Mentored team members in resolving complex inquiries, enhancing overall team performance.
Education
Some College (No Degree) - B.com
GITAM University
Hyderabad03-2020
Some College (No Degree) - Commerce
Board Of Intermediate
Hyderabad03-2018
SSC -
Board of Secondary Education
Hyderabad01.2014
Key Areas Strength
- Positive Attitude
- Confident
- Seeks and Accepts Responsibility willingly
- Good Communication
- Interpersonal and Empathic listening skills
- Always carving to learn new concepts
- Excellent Leadership qualities
- Problem-solving skills
- Professional Integrity
Accomplishments
- Nominated by the client for special recognition during the annual business review
- Maintained a 98%+ quality score and contributed to reducing the claim backlog by 30% within the SLA
- Recognized as a top performer from Q1 to Q3 2024, handling the highest volume of claims with 98% accuracy
Hobbies Activities
- Playing cricket
- Table tennis
- Listening music
- Trading
Languages
- Hindi
- Telugu
- English
Personal Information
- Father's Name: SURESH PIPRIYEA
- Date of Birth: 09/06/97
- Gender: Male
- Nationality: Indian
Disclaimer
I hereby declare that the information provided above is correct and true to the best of my knowledge.
Timeline
Claims Associate
Optum Global Solution
10.2020 - 01.2025
Claims Representative
Optum global solution
10.2020 - 01.2025
Some College (No Degree) - B.com
GITAM University
Some College (No Degree) - Commerce
Board Of Intermediate
SSC -
Board of Secondary Education
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