Qualification Summary : B.H.M.S - Bachelors of Homoeopathy In Medicine & Surgery. Has knowledge of Homoeopathy as well as Allopathy medicine with all medical terminology. 3 years and 4 months experience as a claim adjuster in Raksha TPA Pvt. Ltd. i.e. Third party administrator company settling mediclaims (Health insurance claims) on behalf of government insurance companies. 2 years experience as a medical officer in a hospital of M.D. Physician that provides indoor and outdoor patient department & emergency service. 3 years experience as a Study physician in Clinical Pharmacological Unit of Sun Pharmaceutical Pvt. Ltd. Company conducting clinical trials. Extensive usage of programs such as: MS Word (data-typing with approximate 50-55 words per minute), MS Excel, MS PowerPoint with good computer knowledge. Hands on experience in reviewing claims as per medical grounds and policy terms and conditions of insurance company and making final decisions for claim adjustment, auditing claims, making monthly report data for insurance company, investigation for fraudulent claims. In hospital, managing OPD & IPD patients and maintaining daily orders, preparing discharge summary, history sheet of patients. In clinical trials screening of volunteers with completion of all screening documents, taking vitals as per SOP, check-in & check-out of volunteers. Excellent medical knowledge, interpersonal, verbal and written communication skills. Highly respectful and adhere to privacy and confidentiality policies. Organized and detailed oriented, complete tasks accurately and on time.

Highlights:

• Audit
• Fraud
• Insurance
• Management
• Medical
• Vitals
• Communication Skills
• Government
• Health Insurance
• Insurance Claims