Pankajj Kumar Email and Phone Number
With 14 years of specialized experience in the US healthcare industry, Pankajj Kumar is a detail-oriented and results-driven professional focused on Healthcare Revenue Cycle Assessment & Optimization, Healthcare Data Modeling & Analytics, Payor/Provider Operations, Payment Integrity, Policy & Measure Development (encompassing both Business & Clinical Rules), Business & System Requirements, and Market Research.I specialize in healthcare management consulting, leading large-scale transformations to enhance operational efficiency and effectiveness within healthcare organizations. I excel in developing Target Operating Models customized to meet the specific needs of healthcare institutions, ensuring alignment of operational processes with strategic objectives.My strong background in Healthcare Data & Analytics allows me to apply advanced analytical tools and methodologies to generate actionable insights, supporting informed decision-making within the healthcare sector. Additionally, I am actively engaged in business development initiatives, identifying growth opportunities, and contributing to innovative solutions that address the dynamic challenges of healthcare industry.I am excited about joining forces with fellow professionals! Let's connect and explore how my skills and experience can contribute to the success of your healthcare initiatives.
Exl
View- Website:
- exlservice.com
- Employees:
- 20487
-
ManagerExl Feb 2024 - PresentGurugram, Haryana, India1. Development and Implementation of Data-Driven Strategy Initiatives2. Advanced Healthcare Analytics and Performance Metrics3. Project Management and Execution4. Performance Evaluation and ROI Optimization5. Market Research and Competitive Analysis
-
ConsultantKpmg Oct 2022 - Feb 2024Gurugram, Haryana, India1. Assist clients in devising data-driven strategic solutions for business problems.2. Engagements range from process assessment, financial planning, operational data assessment and planning to market research, benchmarking, and developing analytical solutions.3. Develop user friendly dashboards to report and monitor metrics using SQL, Power BI, Alteryx and MS Excel(VBA).4. Conduct "as-is" state assessment, business process mapping, "to-be" operating model and design future roadmap.5. Create point of view documents on latest topics and support in proposal development. -
Lead - Health Care AnalystExl Jun 2021 - Oct 2022Chennai, Tamil Nadu, India1. Helping payers to improve patient care, enhance member acquisition & engagement, and manage total cost of care.2. Helping providers to improve quality of care & patient outcomes, enhance patient satisfaction, maximize network performance, and optimize revenue.3. Helping PBMs to reduce drug spend, improve medication adherence, and eliminate Fraud, waste, and abuse.Tools & Technologies: Agile Project Management, Healthcare Analytics, Product Analytics, Claims-based Analytics, Pharma Analytics, Python, SAS, SQL, Power BI, and MS Excel (VBA).
-
Business Systems AnalystUnitedhealth Group Jun 2020 - Jun 2021Gurgaon, Haryana, IndiaCreating and delivering high quality system solutions for healthcare applications, products and services that work together in a cohesive manner, enforcing standards and methods consistently across the enterprise. Consulting with users and technology specialists to define business process and the information systems for supporting those processes. Perform data analysis and also serve as business liaison to understand and refine business requirements. -
Associate Research AnalystUnitedhealth Group Nov 2016 - May 2020Noida, Uttar Pradesh, IndiaClinical Informatics - Develop clinical product content and rules which are used by multiple payer and provider products. Content and Rules include Medicare, Medicaid, NCQA and other third party sources. The content and rule development includes NCQA Measures, National and Local Coverage policies (LCD/NCD), State Medicaid and National Medicare and Medicaid policies.
-
Quality Auditor - Medical CodingEli Research India (P) Ltd. May 2016 - Nov 2016Faridabad, Haryana, IndiaResponsible for auditing medical record documentation to identify undercoded and upcoded services; prepares reports of findings and meets with coders to provide education and training on accurate coding practices and compliance issues. Providing second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.Interacts with client and management to review and implement codes and to update charge documents. Ensures strict confidentiality of financial records. Attending coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations. -
Medical CoderR Systems Jan 2015 - Apr 2016Noida Area, IndiaReviews, determines accuracy of and applies the correct coding conventions to patient charge encounters, procedural and surgical services, as defined through physician documentation, regulatory agencies and various third-party payers. Identifying provider specific educational needs relative to professional coding and documentation. -
Analyst-ArE4E Healthcare Business Services May 2014 - Sep 2014Noida Area, IndiaResponsible for using coded data to produce and submit claims to insurance companies, working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid, reviewing and appealing unpaid and denied claims, answering patient’s billing questions, handling collections on unpaid accounts and managing the facility’s Accounts Receivable reports.
-
Claims AssociateUnitedhealth Group May 2013 - Mar 2014Noida Area, IndiaResponsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.
-
Practitioner-CrmIbm Global Process Services Jun 2011 - Feb 2013Gurgaon, India
Pankajj Kumar Education Details
-
Business Statistics/Managerial Economics -
Statistics
Frequently Asked Questions about Pankajj Kumar
What company does Pankajj Kumar work for?
Pankajj Kumar works for Exl
What is Pankajj Kumar's role at the current company?
Pankajj Kumar's current role is Transforming Healthcare with Data-Driven Insights | Strategy & Operations Consulting | Project & Change Management | Payment Integrity | CSM® | LSSGB | CSBI | CSPO® | CPC.
What schools did Pankajj Kumar attend?
Pankajj Kumar attended Delhi University, Indira Gandhi National Open University.
Who are Pankajj Kumar's colleagues?
Pankajj Kumar's colleagues are Himanshu Lamba, Nadeem Khan, Sateesh Ms, Manohar Sekhar, William Banaag, Amrendra Bhadauria, Dheeraj Singhal.
Not the Pankajj Kumar you were looking for?
-
-
-
-
Pankajj Kumar
Uttar Pradesh, India
Free Chrome Extension
Find emails, phones & company data instantly
Aero Online
Your AI prospecting assistant
Select data to include:
0 records × $0.02 per record
Download 750 million emails and 100 million phone numbers
Access emails and phone numbers of over 750 million business users. Instantly download verified profiles using 20+ filters, including location, job title, company, function, and industry.
Start your free trial