Volunteer work
Rajesh Singh
Process Lead (Trainer)
A - 114 Prem Nagar. Delhi
Summary
Adept at processing orders, accepting payments and resolving customer issues. Knowledgeable about training and overseeing team members, helping out in other departments and preparing displays for special promotions. Good time management, multitasking and problem-solving abilities.
Overview
9
9
years of professional experience
6
6
years of post-secondary education
2
2
Languages
Work History
Process Lead (PD)
Genpact India Pvt. Ltd, KRA
03.2019 - Current
- Developed surveys to identify training needs based on projected process and changes.
- Managed all exempt employee coaching, training and performance improvement action.
- Assessed skill gaps for employees in processing the developed training to meet identified needs.
- Trained new hires to perform cross- training exercises with experienced worker.
- Process US Disability Claims (Shot Term Disability and Integrated Claims) bases on the information’s which is provided by Employee, Employer and Attending Physician(APS) and some documents provided by client as well and review on that claim and then give my recommendation on that claim bases on this information
- Worked as an Auditor/trainer (Perform claim audits within the team, identify opportunities & develop implement action plan to address opportunities/findings
- So I am taken my decision (Approval/ Denial) on claims as prior I should give my recommendation on claims
- So now I am working on payment as well
- We have make a payment through decision and sent an Approval/ Denial letter to employee & employer for approval/ denial
- Provide Feedback & direction to the examiners on continuously improving their case management skills
- Manages both new claims & pending claims equally & maintains decision on times
- Prioritize work continually & produce significant volume of work efficiently within performance standards
- Act as a full team member by providing support to peer group during high volume periods & absences
- Handling Pillar Huddle with Clint on Teams Channel for any update on groups & any feedback for particular group & for claims queries as well
- Handling a team of 10 employees by solving queries & providing support to them
- Making Outbound calls to Employee, Employer & Physician for any pending information like Surgery date, Date of Disability, Delivery Date ADD/EDD if not given ect..
Senior Claim Analyst
United Health Group Information Services Pvt Ltd
03.2018 - 02.2019
- Registering the patient and verifying their insurance coverage
- We select the provider as per state we check duplicate services in provided service list
- We check explanation of benefit(EOB) Authorization, also check deductible, co-pay, Co-insurance and mostly allowed amount
- Our most important work is check authorization in file
- All work done by company SOP or Company policies, if we found any lack of Information or error we deny the payment or claim for particular service
- Reviewing and appealing unpaid and denied claim
- Handling collections on unpaid accounts.
Advance Team Member
AON India, Aon Hewitt
11.2014 - 03.2018
- Checking of Insurance Documents (Medical, Dental & Vision) of participant
- Manual Audit on Dependent Account & make decision whether they are eligible to get insurance benefit or not
- Data Analysis and updating the data in PLAN SMART Tool as per process requirements
- Notify Participant by sending Insufficient Letter and ask him/her to submit any additional/missing documents
- Understand client’s values & maintain all SLA’s as per process requirements
- Coaching to new team mates with floor support to resolve any issues or escalations
- Identifying and implementing process improvements and key improvement ideas.
Education
B. Com -
Delhi University
Delhi 04.2011 - 10.2014
10th - General
CBSE Board
Delhi 04.2007 - 04.2008
12th - Commerce
CBSE Board
Delhi 04.2009 - 04.2010
Skills
Computer Knowledgeundefined
Interests
Working on New ideas
Watching Movies
Timeline
Process Lead (PD)
Genpact India Pvt. Ltd, KRA
03.2019 - Current
Senior Claim Analyst
United Health Group Information Services Pvt Ltd
03.2018 - 02.2019
Advance Team Member
AON India, Aon Hewitt
11.2014 - 03.2018
B. Com -
Delhi University
04.2011 - 10.2014
12th - Commerce
CBSE Board
04.2009 - 04.2010
10th - General
CBSE Board
04.2007 - 04.2008
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