Shubham Sagar
Pune
Summary
Claims processing in healthcare refers to all the steps needed to obtain payer reimbursement that coincide with all the services given to a patient. Once the health plan completes processing the claim, it sends a payment to the doctor's office for the cost covered by the plan and tells them what you still owe to cover the full cost.
Overview
4
4
years of professional experience
Work History
Advisor II Transaction Processing
Concentrix Daksh India Pvt ltd
Pune
08.2020 - Current
- Reviewed customer insurance claims to ensure accuracy and completeness of information.
- Analyzed claim records, policy provisions, and other relevant documents to determine validity of claims.
- Calculated benefit payments based on policy terms, coverage limits, and applicable regulations.
- Resolved customer complaints related to insurance claim processing.
- Collaborated with team members to identify trends in customer issues and develop solutions accordingly.
- Maintained detailed records of all claim activities including correspondence, decisions, payments.
Education
BE in Computer Science -
G.H. Raisoni College of Engineering
Pune05-2021
Skills
- Relationship Building
- Presentations and public speaking
- Teamwork and Collaboration
Languages
Marathi
First Language
English
Intermediate (B1)
B1
Hindi
Intermediate (B1)
B1
Timeline
Advisor II Transaction Processing
Concentrix Daksh India Pvt ltd
08.2020 - Current
BE in Computer Science -
G.H. Raisoni College of Engineering
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