Summary
Overview
Work History
Education
Skills
References
Certification
Timeline
Generic
PAWAN KUMAR TIWARI

PAWAN KUMAR TIWARI

Senior analyst
Faridabad

Summary

A seasoned professional with over 4 years of experience in data analysis, claims and appeals management, and client relations. Proven track record in mentoring junior coordinators and maintaining high-quality audit scores, leading to enhanced member and provider satisfaction. Strong analytical, problem-solving, and communication skills, combined with a commitment to delivering timely and accurate results.

Overview

7
7
years of professional experience
2
2
Certifications
2
2
Languages

Work History

Senior Analyst

Concentrix Daksh Services India Pvt. Ltd
08.2015 - 09.2022
  • Client: UnitedHealth Group
  • Core Responsibilities:
  • 1. Data Analysis: Research and analyze data to identify errors and inconsistencies.
  • 2. Documentation and Review: Ensure accurate and timely documentation, review, routing.
  • 3. Issue Differentiation: Differentiate between Inquiries, Grievances, Appeals, Claim Disputes.
  • 4. Claim History Review: Review claim history to determine eligibility for payment.
  • 5. Reporting: Report instances of medical staff errors or negligence.
  • 6. Auditing and Mentoring: Audit and mentor junior appeal coordinators.
  • 7. Escalation Management: Manage escalated cases effectively.

Education

Bachelor of Science -

The Global Open University,
Nagaland
04.2001 -

No Degree - 12th

SRI L.D.R.D INTER COLLEGE
Ballia, India
04.2001 -

High School Diploma -

SRI L.D.R.D INTER COLLEGE
Ballia, India
04.2001 -

Skills

References

Naresh shing Rathor, Project Manager - 97249 41989

Certification

Oracle Databases 9i-SQL

Timeline

Senior Analyst

Concentrix Daksh Services India Pvt. Ltd
08.2015 - 09.2022

Oracle Databases 10g:PL/SQL

10-2010

Oracle Databases 9i-SQL

06-2010

Bachelor of Science -

The Global Open University,
04.2001 -

No Degree - 12th

SRI L.D.R.D INTER COLLEGE
04.2001 -

High School Diploma -

SRI L.D.R.D INTER COLLEGE
04.2001 -
PAWAN KUMAR TIWARISenior analyst