Shivam Pandey
Surat
Summary
Dedicated medical authorization specialist demonstrating robust work ethic and unwavering determination to execute tasks promptly, ensuring exceptional medical billing experiences for providers.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Insurance Authorization Specialist
Synergy Info Outsourcing Pvt Ltd
02.2023 - Current
- Processed prior authorization requests using multiple platforms, including Availity, UHC, Carelon, Evicore, Covermymeds etc.
- Coordinated with insurance companies to secure timely approvals for authorizations.
- Managed appeals for denied authorizations, collaborating with insurance companies to achieve resolutions.
- Verified patients' eligibility for insurance benefits, ensuring compliance with policy requirements.
- Streamlined referral processes by coordinating effectively with patients and primary care providers.
Head of Product
Aclore Wings Pvt Ltd
09.2020 - 01.2023
- Co-ordinated with the faculties to find out topics that are going to be recorded and published on the website
- Identified issues impacting student experience on the website
- Developed solutions to address student issues on the website
- Coordinates with faculties to schedule live lectures and advertise them on social media platforms with the marketing team help.
Customer Service Representative
Shields B2B Pvt Ltd
05.2019 - 09.2019
- Called IT Manager and IT director of US Companies to inform them about our anti-malware software.
- Sent emails with our product details and followed up with the potential client.
- Communicated product information via email to engage potential clients.
- Worked in US shift. Called IT Manager and IT director to inform them about our anti-malware software.
Education
BBA - Marketing Management
Veer Narmad South Gujarat University
Surat04-2022
HSC - Science
Nelson’s Higher Secondary School
Ahmedabad03-2018
SSC -
Image English School
Ahmedabad 03-2016
Skills
- Experience working with Medicare and Medicaid
- Experience working with ECW, Tebra, Advance Md, IMS software
- Experience working with commercial insurances such as Humana, UHC, Molina, Wellcare, Meridian, BCBS and more
- Experience working on Sleep Medicine, Podiatry, Ophthalmology and Orthopedic services
- Knowledge of ICD 10 and CPT codes
- Microsoft Excel and Word proficiency
Languages
English
Proficient (C2)
C2
Hindi
Proficient (C2)
C2
Gujarati
Proficient (C2)
C2
Certification
Business and Startup Management course by Government of India
Accomplishments
Best Employee of the Year 2025, Synergy Info Outsourcing Pvt Ltd.
Additional Skills
- Communication skills
- Organizational skills
- Leadership
- Problem-solving
Declaration
I hereby declare that the information provided in this resume is true and accurate to
the best of my knowledge.
Shivam Pandey
Timeline
Insurance Authorization Specialist
Synergy Info Outsourcing Pvt Ltd
02.2023 - Current
Head of Product
Aclore Wings Pvt Ltd
09.2020 - 01.2023
Customer Service Representative
Shields B2B Pvt Ltd
05.2019 - 09.2019
BBA - Marketing Management
Veer Narmad South Gujarat University
HSC - Science
Nelson’s Higher Secondary School
SSC -
Image English School