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 -
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