Sagar Gakhare
Advance Associate
Pune
Summary
Professional Summary:
Experienced and detail-oriented Healthcare Third Party Administrator with over 3 years of experience in managing health benefits, claims processing, and compliance with healthcare regulations. Skilled in coordinating between healthcare providers, insurance companies, and patients to ensure seamless service delivery. Demonstrated ability to analyze complex data, improve operational efficiency, and maintain high standards of customer service. Committed to upholding patient confidentiality and enhancing client satisfaction through effective problem-solving and communication.
Overview
4
4
years of professional experience
45
45
years of post-secondary education
3
3
Languages
Work History
Advance Associate
Illumifin India LLP
02.2023 - Current
- Managed the administration of health benefits and worked on multiple projects for various clients, ensuring compliance with healthcare regulations and company policies.
- Handled more than six clients using multitasking and quality management skills, and maintained timely communication with the onshore team regarding new projects and trainings.
- Processed and adjudicated healthcare documents efficiently, reducing processing times by 15%.
- Coordinated with healthcare providers, insurance companies, and patients to resolve claims and coverage issues.
- Conducted thorough audits of medical records and claims to ensure accuracy and compliance with HIPAA guidelines.
- Developed and implemented standard operating procedures to enhance the efficiency of work processing and administration.
Associate
SS&C
08.2021 - 01.2023
- Provided timely projects training to new employees.
- Analyzed healthcare data to identify discrepancies and areas for improvement.
- Prepared detailed reports and summaries for internal and external audits, highlighting key findings and recommendations.
- Maintained high standards of quality and productivity, consistently meeting or exceeding departmental goals.
- Collaborated with IT teams to resolve issues promptly, ensuring minimal disruption to audit processes.
- Provided effective and timely support during audits, ensuring the highest level of client satisfaction.
Education
B.Tech - Mechanical Engineering
Guru Nanak Institution of Engineering
04.2001 - 06.2020
High School Diploma -
Vijay Nimbalkar Jr Collage
04.2001 - 05.2015
SSC Board -
Indira Gandhi High School
04.2001 - 05.2013
Skills
- MS Office, Excel
- Quality Check
- Billing & Payments
- Backend Operation
- Process Improvement
- Claims Processing
Declaration
I hereby declare that all the given information above holds good to the best of my knowledge and ability.
Date:-
Place:-
Timeline
Advance Associate
Illumifin India LLP
02.2023 - Current
Associate
SS&C
08.2021 - 01.2023
B.Tech - Mechanical Engineering
Guru Nanak Institution of Engineering
04.2001 - 06.2020
High School Diploma -
Vijay Nimbalkar Jr Collage
04.2001 - 05.2015
SSC Board -
Indira Gandhi High School
04.2001 - 05.2013
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