Summary
Overview
Work History
Education
Skills
Languages
Certification
Timeline
Generic

Rahul Kumar

Noida

Summary

Adept TPA Administrator with a proven track record at MANAS HOSPITAL PVT.LTD, enhancing workflow optimization and claims management. Spearheaded policy administration improvements, boosting efficiency and compliance. Demonstrates exceptional leadership and document management skills, ensuring meticulous oversight and strategic direction in health plan administration.

Overview

2
2
years of professional experience
1
1
Certification

Work History

TPA Administrator

MANAS HOSPITAL PVT.LTD
NOIDA
01.2024 - Current
  • Negotiated terms with third party vendors for services such as IT support or claims processing software applications.
  • Followed up with customer accounts to resolve unpaid or past due accounts.
  • Coordinated with IT department to resolve technical issues and maintain computer systems.
  • Audited company's legal documents to verify compliant policies and procedures.
  • Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
  • Improved office organization by developing filing system and customer database protocols.
  • Managed day-to-day office operations, ensuring efficient workflow and adherence to policies.
  • Provided oversight and direction to the TPA team on all aspects of health plan administration.
  • Developed, implemented and maintained procedures related to claim processing, customer service, benefit plans and enrollment activities.

TPA Coordinator

suman super speciality hospital
NEW DELHI
06.2022 - 10.2023
  • Provided oversight and direction to the TPA team on all aspects of health plan administration.Claim Processing pre auhtorization, Final Approval Claim Document Submitted . Claim tracked and Time to Time Payment Record check,Plan Case of Follow up and All Over Tpa Related Work Done

Education

Bachelor of Computer Applications - Computer And Information Sciences

C.M.COLLEGE DARBHANGA
Darbhanga
04-2021

Master of Computer Applications - Computer And Information Sciences

DIWAN V.S.GROUP OF INSTITUTE AND MANAGEMENT SYSTEM
NOIDA MERUTE

Skills

  • Policy administration
  • Claims management
  • Workflow optimization
  • Underwriting
  • Resource optimization
  • Policy writing
  • Contract administration
  • Document management
  • Employee supervision
  • Work Planning and Prioritization
  • Customer service
  • Risk management
  • Timesheet processing
  • Multi-line phone systems
  • Honest and ethical
  • Leadership

Languages

Hindi
First Language
English
Beginner
A1

Certification

  • PRIME MINISTER KAUSHAL VIKAS YOJANA

Timeline

TPA Administrator

MANAS HOSPITAL PVT.LTD
01.2024 - Current

TPA Coordinator

suman super speciality hospital
06.2022 - 10.2023

Bachelor of Computer Applications - Computer And Information Sciences

C.M.COLLEGE DARBHANGA

Master of Computer Applications - Computer And Information Sciences

DIWAN V.S.GROUP OF INSTITUTE AND MANAGEMENT SYSTEM

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Rahul Kumar