Summary
Overview
Work History
Education
Skills
Certification
LIFE PHILOSPHY
STRENGHTS
Timeline
Generic

ILMA KHAN

NEW DELHI

Summary

Dynamic Senior Claims Associate at OPTUM GLOBAL SOLUTIONS with expertise in claims analysis and regulatory compliance. Proven track record in mentoring junior associates and enhancing training programs. Skilled in fraud detection and data reporting, driving process improvements while delivering exceptional customer service. Committed to achieving operational excellence and fostering team collaboration.

Overview

5
5
years of professional experience
1
1
Certification

Work History

Senior Claims Associate

OPTUM GLOBAL SOLUTIONS
NEW DELHI
02.2024 - Current
  • Prepared detailed reports summarizing claim activity, successes, and areas of improvement for upper management review.
  • Provided guidance and training to junior associates on effective claim processing techniques.
  • Monitored daily workloads to prioritize time-sensitive tasks for completion.
  • Conducted internal audits of completed claims files to ensure accuracy and completeness of records.
  • Conducted follow-up sessions to ensure that new hires were properly assimilating into the workplace environment.
  • Developed and implemented new hire training plans for employees.
  • Conducted regular assessments to monitor mentee progress and adjust mentoring strategies as needed.
  • Implemented strategies to take advantage of new opportunities.
  • Oversaw quality control to identify inconsistencies and malfunctions.
  • Provided subject matter expertise and guidance to cross-functional teams.

Claims Associate

OPTUM GLOBAL SOLUTIONS
NEW DELHI
11.2020 - 01.2024
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
  • Monitored trends in fraud activity and developed protocols for identifying suspicious activities requiring further investigation.
  • Provided technical advice on complex claim issues to internal staff members.
  • Reviewed documentation and accounts to gain full picture.

Intern

Sir ganga ram hospital
NEW DELHI
01.2020 - 04.2020
  • Identified and properly documented patient goals, evaluated progress and planned reevaluation.
  • Used treatment tables to carefully examine patients and determine proper treatment.
  • Implemented preventative measures through health promotion activities such as ergonomics training or postural awareness instruction.
  • Educated patients on most effective practices for pain alleviation, strengthening and rehabilitation.

Education

BACHELORS IN PHYSIOTHERAPY - Health And Physical Fitness

SCHOOL OF ALIED HEALTH SCIENCES
SHARDA UNIVERSITY, GREATER NOIDA
01-2019

Skills

  • Claims analysis
  • Fraud detection
  • Data reporting
  • Documentation review
  • Team collaboration
  • Employee training
  • Process improvement
  • Effective communication
  • Mentoring strategies
  • Auditing processes
  • Problem resolution
  • Time management
  • Database management
  • Conflict resolution
  • SQL database management
  • Report preparation
  • Advanced Excel certified
  • Data handling
  • Good knowledge of DX, CPT and HCPC codes

Certification

  • Professional Academy for Health Care Management (AHM 250)

LIFE PHILOSPHY

'If you don't have any shadows, you are not standing in light'

STRENGHTS

  • Time management.
  • organization
  • Detail oriented

Timeline

Senior Claims Associate

OPTUM GLOBAL SOLUTIONS
02.2024 - Current

Claims Associate

OPTUM GLOBAL SOLUTIONS
11.2020 - 01.2024

Intern

Sir ganga ram hospital
01.2020 - 04.2020

BACHELORS IN PHYSIOTHERAPY - Health And Physical Fitness

SCHOOL OF ALIED HEALTH SCIENCES

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ILMA KHAN