Pavan Kumar Singh Chowhan
Hyderabad
Summary
Personable and dedicated Senior Support Specialist with extensive experience in health care domain. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
10
10
years of professional experience
Work History
Senior Support Specialist
Cotiviti India Private Limited
Hyderabad
07.2018 - Current
- Verified insurance coverage and eligibility for services provided.
- Researched policy provisions to determine coverage levels, limitations, and exclusions.
- Conducted reviews of medical records for compliance with payer requirements.
- Reviewed provider reimbursement requests for accuracy and adherence to contractual agreements.
- Investigated complex cases involving multiple providers, services, or diagnoses.
- Provided education and guidance on appeal rights when a claim is denied or partially paid.
- Performed audits on provider billing practices to ensure compliance with regulations.
- Analyzed data from previous payments made by the insurer in order to set appropriate payment rates.
- Monitored performance metrics such as turnaround time, quality control measures.
- Collaborated with other departments within the organization in order to resolve issues quickly.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
- Performed daily system monitoring, verifying the integrity and availability of all hardware, server resources, systems and key processes.
- Tested patches and updates on test environments prior to deploying them into production environment.
Support Specialist
Tata Business Support Services
Hyderabad
03.2014 - 07.2018
- Processed customer orders received via telephone, fax and email for accuracy and completeness.
- Updated customer order information into the system in a timely manner to ensure delivery deadlines were met.
- Coordinated with suppliers to ensure availability of items ordered by customers.
- Maintained accurate records of all orders processed daily to track progress and follow up on any discrepancies or delays.
- Resolved customer inquiries regarding products, pricing, shipping status and other related issues promptly.
- Reviewed returned merchandise for damage before processing refunds or exchanges.
- Generated reports from the system as needed for management review and analysis.
- Provided excellent customer service through effective communication with customers throughout the ordering process.
- Monitored inventory levels to determine when additional stock needs to be purchased from vendors.
- Collaborated with sales team members to ensure timely deliveries of high priority orders.
- Ensured compliance with all applicable laws and regulations related to retail operations.
- Provided training and guidance to new team members on order processing tasks and responsibilities.
- Participated in regular meetings with internal teams such as logistics, accounting, marketing, to discuss current processes and brainstorm solutions for better efficiency.
- Communicated with customers to assist with order placement and offer updates on status and shipping.
Education
Bachelor of Science - Electronics Technology
Osmania University
Hyderabad04-2013
Skills
- SQL knowledge
- SQL understanding
- Excel and SQL mastery
- SLA management
- Client Relationship Building
- Communication proficiency
- Remote Support
- Customer communications
- Training and mentoring
- Customer Support
Accomplishments
- Received Spotlight award for best contributions made.
- Received R&R (Best Performer) for supporting the entire team to achieve the KPI's.
Languages
Hindi
First Language
English
Proficient (C2)
C2
Telugu
Proficient (C2)
C2
Timeline
Senior Support Specialist
Cotiviti India Private Limited
07.2018 - Current
Support Specialist
Tata Business Support Services
03.2014 - 07.2018
Bachelor of Science - Electronics Technology
Osmania University
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