JEETENDRA PANDEY
Gurgaon
Summary
Seeking an entry level position in business with a progressive organization in order to utilize my education and 4 years of work experience. I am a team player and adapt to new systems and procedures quickly. I also have excellent communication skills in attending to customer issues and concerns. Over 4 years of experience in health industry. Excellent reputation for resolving problems and improving customer satisfaction.
Experienced Appeals Analyst with a comprehensive understanding of case.
Overview
5
5
years of professional experience
6051
6051
years of post-secondary education
Work History
Appeals Analyst
Concentrix Daksh Services Pvt. Ltd.
02.2024 - Current
- Analyzed customer appeals to determine eligibility for service adjustments.
- Reviewed documentation to ensure compliance with company policies and regulations.
- Collaborated with cross-functional teams to resolve complex customer issues efficiently.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Managed denials, late payments, extensions and other special circumstances by following up with relevant parties.
AR Caller
Concentrix Daksh Services Pvt. Ltd.
03.2023 - 01.2024
- Conducted follow-up calls to clients regarding outstanding accounts receivable.
- Managed customer inquiries and resolved payment disputes effectively.
- Documented account details and interactions in the CRM system accurately.
- Educated clients about billing procedures and payment options available.
Claim Processor
Concentrix Daksh Services Pvt. Ltd.
Gurgaon
04.2021 - 02.2023
- Work As Claim Processor
- Coordinate with other insurance to apply correct benefit for copays, coinsurance, and deductibles.
- Processed Medical Insurance claims for Medicare, made corrections and adjustments, medical coding.
- Processed Claims for FEP Dental, HMO/PPO Claims, Nevada Medicaid.
- Monitored claims to ensure accuracy of CPT, ICD-9, and HCPCS coding.
- Issued claim payments according to department procedures, plan benefits and provider contracts.
- Processed over 1000+ medical/hospital claims at an accuracy of over 99%.
Education
Becholor's - Scicence
Thakur Ranmat Singh College
Diploma - Computer Application
Makhanlal Chaturvedi National University of Journalism and Communication
Rewa12th -
Government State School
Skills
- Ability to Work in a Team
- Microsoft Office
- Flexibility and Adaptability
- Computer Skills
- Customer Service Skills
- Knowledge of MS Office
Websites
Hobbies and Interests
- Listing Song
- Book Reading
- Watching Movie
Personal Information
Title: Appeal Processor
Languages
- English
- Gujrati
Timeline
Appeals Analyst
Concentrix Daksh Services Pvt. Ltd.
02.2024 - Current
AR Caller
Concentrix Daksh Services Pvt. Ltd.
03.2023 - 01.2024
Claim Processor
Concentrix Daksh Services Pvt. Ltd.
04.2021 - 02.2023
Becholor's - Scicence
Thakur Ranmat Singh College
Diploma - Computer Application
Makhanlal Chaturvedi National University of Journalism and Communication
12th -
Government State School
Languages
English
Intermediate
B1
Gujarati
Upper Intermediate
B2
Hindi
Advanced
C1