Priyanka Indurkhya
Senior Manager
Pune
Summary
Highly motivated and focused Medical Officer with over 5 years of experience in Third-Party Administration and Dentistry. Currently serving as a Manager and aspiring for leadership roles in reputed organizations.
Overview
10
10
years of professional experience
3
3
Languages
Work History
Manager
Paramount Health Service
04.2022 - Current
- Lead team of 10 doctors for processing reimbursement claims.
- Implemented efficient claims reporting and filing systems.
- Trained new doctors and Para-medicals in claim processing and verification.
- Verified and validated patient's medical documents.
- Mentored junior team members for career advancement, fostering pipeline of future leaders within organization.
Assistant Manager
Paramount Health Service
01.2019 - 03.2022
- Verified and validated patient's medical documents, raised queries when necessary.
- Managed team for processing reimbursement and cashless claims.
- Developed and implemented efficient claims reporting systems.
- Monitored claims with insurance carriers and provided client feedback.
- Improved customer satisfaction by addressing and resolving complaints promptly
Assistant Manager Operations
MD India
01.2018 - 04.2018
- Verified and validated patients' medical documents, raised queries when necessary.
- Managed a team for processing reimbursement and cashless claims.
- Developed and implemented efficient claims reporting systems.
- Monitored claims with insurance carriers and provided client feedback.
- Managed daily operations, ensuring smooth functioning of the organization and consistent delivery of high-quality services.
- Managed daily operations, ensuring smooth functioning of the organization and consistent delivery of high-quality services
Medical Officer
Paramount Health Services
06.2015 - 07.2016
- Managed reimbursement and cashless claim processing.
- Oversaw allocation of work, set objectives for teams, and provided regular feedback.
- Verified discharge summaries and reconciled bills as per policy terms.
- Provided guidance and ministration to team members.
- Reviewed complex cases alongside colleagues during peer consultations to develop consensus on appropriate courses of action for challenging scenarios.
- Reduced hospital readmission rates through effective discharge planning and follow-up care.
Medical Officer
Medi Assist services
10.2014 - 06.2015
- Verified and validated patients' medical documents, reconciled bills.
- Approved cashless claims up to Rs.3,00,000.
- Managed claim department and supervised claim processors.
Dental Surgeon
Advanced Dental Clinic
01.2014 - 10.2014
- Conducted dental procedures including cavity preparation, root canal treatment, extractions, etc.
- Marketed dental services and managed administrative tasks.
- Maintained detailed patient records, tracking progress and adjusting treatments as needed.
- Assisted colleagues in more specialized procedures such as root canal therapies or orthodontic treatments when necessary to ensure optimal results for patients.
- Treated severe cavities, infections and other issues in over 100 patients
Education
BDS (Bachelor of Dental Surgery) - Dentistry (Pre-Dentistry)
Jiwaji University
Gwalior 04.2001 -
Skills
Medical Claims Processing: Expertise in efficient processing of cashless and reimbursement claims, including verification, validation, and reconciliation of medical documents
Time Management: Efficient in managing multiple tasks, prioritizing workload, meeting deadlines, and ensuring timely processing of claims
Team Leadership: Skilled in leading and training teams of medical officers, doctors, and para-medical staff in claim processing procedures and compliance with insurance policies
Policy Compliance: Deep understanding of insurance policies, terms, and conditions to ensure accurate and compliant claim processing
Risk Management: Skilled in identifying and mitigating risks, ensuring compliance with regulatory standards, and collaborating with legal and compliance teams
Technical Proficiency: Familiarity with claims management software, medical coding, billing practices, and electronic health records (EHR) systems for streamlined claim processing
Problem-Solving and Decision-Making:Strong analytical and decision-making skills to address complex claim issues, make informed decisions, and prioritize tasks effectively
Time Management: Efficient in managing multiple tasks, prioritizing workload, meeting deadlines, and ensuring timely processing of claims
Personal Information
- Date of Birth: 06/04/88
- Nationality: Indian
- Marital Status: Married
Timeline
Manager
Paramount Health Service
04.2022 - Current
Assistant Manager
Paramount Health Service
01.2019 - 03.2022
Assistant Manager Operations
MD India
01.2018 - 04.2018
Medical Officer
Paramount Health Services
06.2015 - 07.2016
Medical Officer
Medi Assist services
10.2014 - 06.2015
Dental Surgeon
Advanced Dental Clinic
01.2014 - 10.2014
BDS (Bachelor of Dental Surgery) - Dentistry (Pre-Dentistry)
Jiwaji University
04.2001 -