*Currently working at Evolent Health International Private Limited.*Claims Analyst with Over 2 years of experience as Power Bi developer on development of reports and Dashboards using Power BI. *Highly skilled in Design and develop data models to support reporting requirements.

*Proficient level adjudicator providing strong analytical skills to review claim rules and workflows and Responsible for adjudicating claims .*Responsible for handle COVID19 project Claims, flag claims and Commercial claims.*Ability to Process high dollar claims and create inquiries if claim paid/reject incorrectly to receive/give refunds.*Effective communications with supervisors regarding claim issues including claim adjudication, over payments, underpayments or any other… Show more *Proficient level adjudicator providing strong analytical skills to review claim rules and workflows and Responsible for adjudicating claims .*Responsible for handle COVID19 project Claims, flag claims and Commercial claims.*Ability to Process high dollar claims and create inquiries if claim paid/reject incorrectly to receive/give refunds.*Effective communications with supervisors regarding claim issues including claim adjudication, over payments, underpayments or any other irregularities.*Meets all production, quality standards and attends all required training courses and Support to the new hires while they Handling claims Show less

*Maintain confidentiality of all information, policies and procedures as required by the HIPAA Protocols.*Knowledge of policy concepts like Deductible, Coinsurance, Co-pay, Out of pocket.*Reviews, evaluate and make appropriate approval or denial decisions on claims.*Ensured to take the corrective action steps using enrolment, benefit and historical claim processing information and inquiries.*Handled Member, provider, Managecare, duplicate,benefits and pricing related suspensions.