To bring to your Organization enthusiasm, dedication, responsibility and good work ethic, combined with a desire to utilize my skills and experienceEducational Qualification :
BHMS- Bachelor Of Homoeopathic Medicine and Surgery from Maharashtra university of health science (L.M.F.’s homoeopathic medical college, pune)
CCH- Certificate Course in Child Health from Boston University
CGO- Certificate Course in Gynecology and Obstetrics from Boston UniversityComputer Knowledge :
Having knowledge of operating systems like window 95,98,2000, XP and also proficient with MS Word, Excel and Power point.Company profile :Bajaj Allianz Life Insurance Company :
Bajaj Allianz Life Insurance Company Limited is a union between Allianz SE, one of the world’s largest life insurance company and Bajaj Auto, one of the biggest 2 & 3 wheeler manufacturers in the world. Allianz SE is leading insurance conglomerate globally and one of the largest asset managers in the world. Managing assets worth over a Trillion Euros (Over R.55, 00,000 cores). Allianz SE has over 115 years of financial experience in over 70 countries.Designation : Sr.Executive Operation (L1-A)Duration : From 1st December 2007 till date.Job responsibilities :
** Working in underwriting team As a Sr.Executive operation. Since dec 2007.
** Having total experience of 6 yrs ( 1 yrs clinical experience , 1 year TPA ,i.e. health underwriting & 4 years of life underwriting)
** Cross functioning experience- many times help to claims dept for medical opinion.
** Underwriting health & life cases, having experience to handle HNI / PRIORITY cases
** Having STD authority up to 30 lakh and SUB STANDARD authority up to EMR +100 up to 15 lakh.
** Branch / HUB audit of medical & non medical cases.
** Training to team member’s in medical aspects of underwriting
** Evaluating medical and financial risk during processing the proposal.
** Hub coordination for Coimbatore hub
** First level escalation for SCB (Standard chartered bank) for south zone.
** Working in BANKA team (priority cases)
** Preparing different presentation & training to team members of medical terminology
** Underwriting of TOP UP. Sponsored links :
/ and policy servicingCross functioning :
Currently working with BPR TEAM (business process reengineering) for the process called AUTO BBU (AUTO BLACK BOX UNDERWRITING)Job responsibilities :
** Preparing MIS report on daily basis.
** Software testing.
** Preparing feedback for IT dept.
** Preparing confusion matrix on daily basis.
** Rule configuration for software.
** Product validation for process.
** Preparing QC (quality check) for process.Company profile :
MD India Health Care services
MD India Health care (P) Ltd. Was founded in November 2000, aimed at providing “ Third Party Administration services in Indian health insurance sector” Insurance Regulatory And Development Authority” has issued this TPA license in the year March 2001 (License no. 005)
The company is equipped to handle over 1 million policyholders with state of the art technology and have an in house software team to develop and maintain the software.Designation : TEAM LEADER (CLAIMS DEPT)
Handled major zones across India for claims related query.
Rewarded for achieving targets before time.
Promoted as a TEAM LEADER in probation period based on excellent WorkDuration : From 1st January 2007 to 30th November 2007.Job responsibility :
** Monitoring claims management services including evaluation of all claims data entry with adjudication.
** Evaluating hospital pre certification, concurrent and retrospective review. Certification of focused outpatient procedures, treatment plan review, case management for chronic and large cases, large cases alert, hospital bill audit home health review and fee negotiation.
** Having better control on monitoring on claims.
** Providing inputs, feedback and suggestion on trends and issues in the case of corporate policies and health care industry.
** Having experience to handle team of 8-10 people
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