Open To Work
Tunna Kamti
Gurugram
Summary
Experienced health insurance professional with 4+ years of hands-on expertise in claims analysis and benefits administration within U.S. healthcare plans. Skilled in end-to-end claims processing, benefit configuration, eligibility verification, and appeals handling. Recognized for strong analytical skills, attention to detail, and consistent delivery of accurate claim resolutions while supporting members, providers, and internal stakeholders
Overview
4
4
years of professional experience
4037
4037
years of post-secondary education
Work History
Senior Analyst
Aptia Group Pvt Ltd
01.2024 - Current
- Administer employee benefit programs including health insurance, dental, vision, life insurance, and retirement plans.
- Process benefit enrollments, changes, and terminations in accordance with company policies and client requirements.
- Review and validate benefit data to ensure accuracy and compliance with plan guidelines.
- Handle employee and client queries related to benefits, eligibility, coverage, and claims through multiple communication channels.
- Coordinate with internal teams, insurance providers, and external vendors to resolve discrepancies and ensure smooth operations.
- Maintain and update employee benefit records in HR systems and databases.
- Ensure compliance with regulatory requirements and company policies, including data privacy standards.
- Assist in benefits audits, reporting, and documentation to support business needs.
- Support open enrollment activities and communicate benefit options clearly to employees.
- Identify process improvement opportunities to enhance efficiency and service quality.
Claim Analyst
Us Trpc Pvt Ltd
01.2022 - 01.2024
- Review and scrutinize dental claim, medical & vision documents to ensure accuracy and completeness.
- Process claims in accordance with established healthcare policies and guidelines.
- Provide timely and effective responses to customer inquiries across multiple communication channels, ensuring high-quality service delivery.
- Conduct research on product details, policy provisions, claim statuses, and standard procedures to address customer and internal queries.
- Ensure strict adherence to HIPAA guidelines and data confidentiality standards.
- Accurately process dental claims while meeting productivity and quality benchmarks.
- Apply strong knowledge of claims adjudication principles to evaluate and process claims effectively.
- Demonstrate understanding of ICT and CPT coding systems.
- Utilize knowledge of insurance concepts such as deductibles, co-insurance, co-payments, and out-of-pocket expenses.
- Adapt quickly to process updates and effectively implement guidelines in daily operations.
- Collaborate as a team player and efficiently navigate multiple systems and tools.
Education
Bachelor of Science -
L.N.M UNIVERSITY
Adca -
N.I.C.T DELHI
Skills
- Strong knowledge of benefits administration and insurance concepts
- Excellent attention to detail and data accuracy
- Strong analytical and problem-solving abilities
- Excellent communication and customer service skills
- Attention to detail and accuracy
- Ability to work in a fast-paced, target-driven environment
- Adaptability and willingness to learn
- Ability to manage multiple tasks and meet deadlines
- Problem-solving mindset and adaptability
Websites
Personal Information
Father : Rambalak kamti
Dob : 1st Feb 1995
Gender : Male
Intrest
Exploring on internet
Playing & watching cricket
Languages
English
Advanced
C1
Hindi
Proficient
C2
Work Preference
Job Search Status
Open to workWork Type
Full TimeLocation Preference
HybridRemoteOn-SiteSalary Range
₹45000/yr - ₹200000/yrTimeline
Senior Analyst
Aptia Group Pvt Ltd
01.2024 - Current
Claim Analyst
Us Trpc Pvt Ltd
01.2022 - 01.2024
Bachelor of Science -
L.N.M UNIVERSITY
Adca -
N.I.C.T DELHI