Summary
Overview
Work History
Education
Skills
Timeline
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Nirmit Kumar

Noida

Summary

Seeking a challenging position in a professional organization that offers an opportunity for growth where my talent and experience can be harnessed to contribute to the productivity and performance to the organization, thereby enabling mutual enrichment.

Overview

7
7
years of professional experience

Work History

Senior Executive

CHCS
09.2023 - Current
  • Working in Quality claims assurance team to conduct audit & reviews of various processes . This includes auditing of healthcare claims processing , provider network management etc !
  • We have to maintain the quality standard as per the SOP standards
  • The main focus is to follow the privacy protection (such as HIPAA) & reimbursement policies !
    We need to maintain the daily TAT for the claims !

Senior Executive

Coforge
04.2021 - 08.2023
  • Applied ICD-10 inpatient codes for diagnoses and procedures (Diagnostic Related Group is automatically assigned by the grouper software) for inpatient stays
  • Led special and targeted assignments for the senior leadership team
  • Billing and coding fluency
  • Maintaining Daily TAT for the claims as per the defined process
  • Maintained a superior quality rating of 94% in file handling and claims resolution, exceeding the 85% departmental goal
  • Daily Claim target crossed beyond the departmental target assigned
  • Focusing on the Customer Centric Experience, complaints, feedbacks Esclations etc
  • Conduct Audit of Regular claims for the Quality Assurance

Executive

Future Generali India Insurance Company
06.2019 - 02.2021
  • Processed different types of claims as per the assigned task
  • Claims such as Personal Accident , Reimbursement , Cashless are been processed & audited
  • Payment Mode through NEFT made to the Corporate, Client, Insured a/c
  • Focusing on the Customer Centric Experience, complaints, feedbacks etc
  • Daily Claim target crossed beyond the departmental target assigned
  • Developed a strong understanding of insurance policies of Retail product, Group Health as well as corporate product
  • Maintained a superior quality rating of 94% in file handling and claims resolution, exceeding the 85% departmental goal
  • Maintaining Daily TAT for the claims as per the defined process
  • Awarded as the Employee of the Month for the performance

Operation Officer

Bajaj Allianz General Insurance
08.2017 - 06.2019
  • Processed Claim forms as well as assigned claims
  • Manage & Distribute co- pay , Reimbursement , Cashless Denied case
  • Conduct Audit of Regular claims for the Quality Assurance
  • Payment to corporate, Clients, IMD through NEFT
  • Resolve the issue regarding customer complaints & claim adjudications
  • Daily claim processed beyond the Departmental Target assigned
  • Maintained a superior quality rating of 94% in file handling and claims resolution, exceeding the 85% departmental goal
  • Developed a strong understanding of insurance policies of Retail product as well as corporate product
  • Awarded with Bonus rating A+ for the top performer

Education

CBSE in SSC -

K Lion School

NIOS Board in HSC -

Open School

University Of Pune in Bachelor of Business Administration (BBA) -

Arihant College (ACS)

University Of Pune in Master of Business Administration (MBA) -

Arihant College (ACS)

Skills

  • MS- Word
  • MS-Excel
  • MS-PowerPoint
  • Positive Attitude
  • Punctuality
  • Communication & Interaction in English
  • Hindi

Timeline

Senior Executive

CHCS
09.2023 - Current

Senior Executive

Coforge
04.2021 - 08.2023

Executive

Future Generali India Insurance Company
06.2019 - 02.2021

Operation Officer

Bajaj Allianz General Insurance
08.2017 - 06.2019

CBSE in SSC -

K Lion School

NIOS Board in HSC -

Open School

University Of Pune in Bachelor of Business Administration (BBA) -

Arihant College (ACS)

University Of Pune in Master of Business Administration (MBA) -

Arihant College (ACS)

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Nirmit Kumar