Somya Singh
Chandigarh
Summary
Detail-oriented quality analyst with expertise in healthcare claims management and process auditing. Proven ability to enhance operational efficiency and maintain HIPAA compliance.
Overview
7
7
years of professional experience
Work History
Quality Analyst
Cigna Healthcare
Noida
01.2025 - Current
- Conduct quality audits on healthcare claims to ensure accuracy and compliance with internal policies and payer guidelines.
- Review processed claims to identify errors in billing, documentation, and claim handling.
- Analyze claim trends and identify root causes of errors or delays in claim processing.
- Provide feedback and guidance to claims teams to improve quality and reduce discrepancies.
- Maintain quality scorecards and performance reports for operational improvement.
- Collaborate with internal teams to enhance service delivery and operational efficiency.
Senior Claims Officer
Cigna Healthcare
Noida
03.2024 - 01.2025
- Reviewed and evaluated healthcare claims to ensure accurate processing and compliance with policy guidelines, enhancing overall claim integrity.
- Assessed eligibility and made claim decisions based on policy coverage and documentation.
- Resolved discrepancies and corrected errors in claim submissions, contributing to improved claims accuracy.
- Analyzed patient information to ensure payment accuracy and prevent claim delays.
- Coordinated with healthcare providers and internal stakeholders to resolve claim-related issues, facilitating timely claim resolution.
Analyst
R1 RCM
Gurgaon
02.2021 - 02.2024
- Analyzed authorization trends to enhance understanding of factors impacting claim processing timelines.
- Secured approvals by effectively communicating with insurance payers and review organizations.
- Verified insurance eligibility and ensured accurate patient information for claim processing.
- Coordinated management of prior authorization requests, ensuring timely collection of documentation from clients.
Staff Nurse
Indraprastha Apollo Hospitals
New Delhi
10.2018 - 02.2020
- Provided comprehensive care to critically ill neonates in a high-acuity hospital environment.
- Collaborated with multidisciplinary healthcare teams to ensure coordinated patient care.
- Maintained accurate documentation to support effective treatment and continuity of care.
- Communicated with patients’ families and provided support during treatment processes.
Education
Post Basic Bsc. Nursing - Nursing
Mata Sahib College of Nursing
Chandigarh12-2023
General Nursing Midwifery - Nursing
Apollo School of Nursing
New Delhi07-2018
Skills
- Claims management
- Quality analysis
- Authorization verification
- Revenue cycle management
- Problem resolution
- Documentation review
- Stakeholder communication
- Data analysis
- HIPAA compliance
Languages
English
Advanced (C1)
C1
Hindi
Advanced (C1)
C1
Timeline
Quality Analyst
Cigna Healthcare
01.2025 - Current
Senior Claims Officer
Cigna Healthcare
03.2024 - 01.2025
Analyst
R1 RCM
02.2021 - 02.2024
Staff Nurse
Indraprastha Apollo Hospitals
10.2018 - 02.2020
Post Basic Bsc. Nursing - Nursing
Mata Sahib College of Nursing
General Nursing Midwifery - Nursing
Apollo School of Nursing