Amit Kumar
RZ-***B, Z Block Gopal Nagar
PH-II, Surakhpur Road,
Near ShivMandirNajafGarh
New Delhi-110043
Mobile:-+919*********
E-mail- **************@*****.***
Career Objective:
Looking for a position where I can acquire experience and build up a long term career by investing best of my professional knowledge and skills to serve the organization.
To gain progressive experience and work for result oriented challenging assignments, which allow me to utilize my administrative.
Educational Qualifications:
E x am P a s s e d Year of Passing Name of Institution B . A ( P a s s ) 2009 W i l l i a m C a r e y U n i v e r s i t y Intermediate (12th)
High School (10th)
2002
1995
N I O S B o a r d
C B S E B o a r d
Work Experience:
1. Bignaz Infotech Pvt. Ltd
Industry : Service Industry
Duration : Feb 2015 to Aug 2020
Designation : Claim Processor
KEY RESPONSIBILITY AREA:
Processed incoming Medicare claims in a timely manner while meeting quality guidelines.
Maintained knowledge on policies and procedures of processing on daily basis.
Worked with team members to ensure consistency among all staff in procedures used.
Detection of suspected fraud and referral for verification of claims
Maintain TATs for Medical Assessment.
Process reimbursement claims following SOPs, applying sound medical judgment based on best practice and in accordance with the conditions & terms of the policies.
Determined if claim submission was completed correctly, verified data and entered into system for adjudication.
Worked directly with beneficiaries to resolve any errors and answer any questions regarding eligibility status.
Reviewed payments history to determine final payment amount, if any
Processed claims adjustments when applicable
Provided independent decision making skills and demonstrated initiatives to resolve issues for internal and external customers
Assists with the training of new hires
Knowledge and use of ICD-9, ICD-10 and CPT coding 2. Bignaz Infotech Pvt. Ltd
Industry : Service Company
Duration : Feb 2012 to Jan 2015
Designation : Back Office Assistant
KEY RESPONSIBILITY AREA:
Supporting the Managers in drafting the periodical Insurance reports, to be presented to the Management by running information system queries.
Producing reports accurately and in a timely fashion
Supporting the Claims Manager in the process of drafting the periodical Claims reports
Responsible for back office functions include clearances, record maintenance, process data as per mapping sheets provided by clients.
3. Bignaz Infotech Pvt. Ltd
Industry : Service Company
Duration : Oct 2009 to Jan 2012
Designation : Data Entry Operator
KEY RESPONSIBILITY AREA:
Responsible for entering customer and account data from source document within time limits.
Compiling verifying accuracy and sorting information to prepare source data for computer entry.
Reviewing data for deficiencies or errors, correcting any incompatibilities and checking output. Computer Proficiency:
Completed One year Diploma in Computer Application (Course contents - Ms Word, Ms Excel, Ms Power Point). And other claim processing related software. Personal Information:
Name : Amit Kumar
Date of birth : 09thNov 1981
Nationality : Indian
Marital Status : Married
Father’s Name : Jagpal Singh
Languages Known : English, Hindi
Hobbies : Exploring Internet
Key Strengths : Team-work, Keen learner and ability to do new things. Delhi Amit Kumar
Dated: