Shipra Gupta
Gurgaon
Summary
Dynamic Clinical Investigator and General Dentist with a proven track record at Optum Global Solutions. Excelled in claims management and clinical research, enhancing compliance and efficiency by 30%. Skilled in data analysis and process optimization, with a knack for collaborative problem-solving and a strong foundation in medical writing.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Clinical investigator
Optum global solutions
Gurugram
02.2023 - Current
- Conducting thorough investigations of healthcare claims to ensure accuracy and compliance with insurance policies and regulations
- Reviewing medical records and summarizing pertinent information for claims processing
- Collaborating with medical professionals and stakeholders to resolve claim disputes and discrepancies
- Utilizing analytical skills to identify potential fraud, waste, and abuse in claims submissions
- Ensuring adherence to ethical standards and regulatory requirements in all investigative processes
- Maintained compliance with state, local, and federal regulations governing insurance, Medicare and Medicaid requirements
- Maintained knowledge of benefits claim processing, claim principles, medical terminology and procedures and HIPAA regulations
General Dentist
Manoj dental clinic
Jaipur
02.2019 - 08.2021
General Dentist
Sharma dental clinic
Narnaul
02.2012 - 12.2016
Education
Data Analyst -
IRAEDUTECH
Online09-2024
PG Diploma - ACR/PV
CareerInPharma
10.2022
Bachelor of Dental Surgery -
Eklavya Dental College and Hospital
Kotputli, Rajasthan01.2011
Senior School Certificate Examination -
Saraswati Senior Secondary School
Narnaul, Haryana01.2006
Secondary School Examination -
Saraswati Senior Secondary School
Narnaul, Haryana01.2004
Skills
- Claims Management
- Clinical Research Practices
- Pharmacovigilance Practices
- Analytical abilities
- MS Word
- Excel
- PowerPoint
- Medical writing
- Data analysis
- Data Integration
- Process Optimization
- Business process modeling
- Consulting
Certification
- Introduction to pharmacovigilance, Uppsala Monitoring Center, 09/01/22
- Introduction to signal Detection, Uppsala Monitoring Center, 09/01/22
- Signal Assessment, Uppsala Monitoring Center, 09/01/22
- Causality Assessment of a single case report, Uppsala Monitoring Center, 09/01/22
- Causality Assessment of case series, Uppsala Monitoring Center, 09/01/22
- Data Analytics Certification Course, Basic to Advance Excel, V lookup, Power BI, AI and Chatgpt, Power Point, Pursuing
Languages
- English
- Hindi
Hobbies and Interests
- Listening music
- Cooking new cuisines
- Travelling and exploring new places
- Drawing
Personal Information
- Date of Birth: 07/15/89
- Nationality: Indian
Additional Qualifications
Eklavya Dental College and Hospital, Kotputli, Rajasthan, 09/01/06, 12/31/11, Active participation in Conferences held by Rajasthan Dental Council, dental workshops etc.
Accomplishments
- GOLD Awards for exceptional contributions throughout the year every year.
- PINNACLE Award for excellent work for MAY-JULY 24.
Languages
Hindi
First Language
English
Proficient (C2)
C2
Timeline
Clinical investigator
Optum global solutions
02.2023 - Current
General Dentist
Manoj dental clinic
02.2019 - 08.2021
General Dentist
Sharma dental clinic
02.2012 - 12.2016
- Introduction to pharmacovigilance, Uppsala Monitoring Center, 09/01/22
- Introduction to signal Detection, Uppsala Monitoring Center, 09/01/22
- Signal Assessment, Uppsala Monitoring Center, 09/01/22
- Causality Assessment of a single case report, Uppsala Monitoring Center, 09/01/22
- Causality Assessment of case series, Uppsala Monitoring Center, 09/01/22
- Data Analytics Certification Course, Basic to Advance Excel, V lookup, Power BI, AI and Chatgpt, Power Point, Pursuing
Data Analyst -
IRAEDUTECH
PG Diploma - ACR/PV
CareerInPharma
Bachelor of Dental Surgery -
Eklavya Dental College and Hospital
Senior School Certificate Examination -
Saraswati Senior Secondary School
Secondary School Examination -
Saraswati Senior Secondary School
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