Dr. Charan Kumar Email & Phone Number

Progress is the emphasized desire which navigates my line of work. I am a disciplined and innovative professional with 16+ years of experience in managing various facets of the business over insurance and health claims with a key focus on medical insurance, claims processing and procedures, insurance payments, and policies of healthcare.My indigenous experience has made me expert in handling Disciplinary Proceedings & De-Empanelment process with hospitals on misrepresentation of claims, fraudulent billing, beneficiary identification, unnecessary procedures, false/misdiagnosis within established service standards. I am inventive at providing continuous efforts to enhance and develop internal controls to implement quality assurance ensuring that the funding and payment of claims processes are error free according to the agreements. I possess demonstrated excellence over building diagnostic centers or wellness/ Rehabilitation centers for cashless services and negotiate rates/discounts and drafting reports on reconciliation of the payments with the providers. I am accountable at mentorship, consultation and guidance to the fraud investigations team to provide recommendations to management on policy, procedure, and/or performance enhancements. I am familiar with medical insurance claims procedures, policies of healthcare, government, commercial policies, and documents.