www.ghpltpa.net Good Health Plan Ltd Chennai, Bangalore, Delhi, Mumbai : Claim processing Executive

[Admin]

Good Health Plan Ltd.– is one of the leading Third Party Administrator – Health Services, has following vacancies in the various positions at various places (i.e., Chennai, Bangalore, Delhi, Mumbai).
Our motto is to place Right person to right position.
Head–Business Development
Minimum 10 years experience in insurance industry with associateship should be able to manage the branches independently at various centers.
Corporate Business Development Executives (5 posts)
Postgraduates with preferably MBA(mktg) with 0-3 years experience in service industry/TPA will be an added advantage.
Claim processing Executives (10 posts)
Graduates/Postgraduates with science back ground minimum experience of 1-2 years in corporate billing-Hospital/TPA.
Network Coordinators (5 posts)
Hospital Administration/any post graduate with 2 experience in Hospital/TPA.
Manager Corporate Relations (5 posts)
Preferably female post graduates with MBA(HR)/PGDBM with 2 years experience in hospital industry/IT/TPA
Help Desk Executives (10 posts)
Preferably female Graduates with pleasing personality, good communication skills and knowledge of computers with minimum of 6 months experience in call center/service industry/TPA
Data Entry Operators (6 posts)
Graduates with minimum of 0.6-1 yrs experience in Data Entry and having good type writing skills.
System Co-ordinator (1 Post)
Computer graduate/PGDCA, well acquainted with system administration/networks with minimum of 1 year experience.
Mail your CVs to careers@ghpltpa.net


http://www.ghpltpa.net

[Guest]

Hi,

Working with leading TPA for last 4 years in different departments.

Looking for batter option.

Rgds,
Abhijit
9678321340

[Guest]

CURRICULUM VITAE
Balagangadhar Tilak. Guntamukkala
MailId :gbg.tilak AT gmail.com
OBJECTIVE :
Want to join a reputed Insurance firm at a respectable post and want to use my expertise and experience from previous work. Want to grow as an individual and want to take the firm to new highs with my dedication and hard work.
EDUCATIONAL QUALIFICATIONS :
- Completed Postgraduate Diploma in Insurance& Risk Management (PGDIRM) in International Institute for Insurance and Finance from Osmania University. (2007-2008).
- Completed Bachelor of Science (Bsc MPE) from Andhra University. (1999-2002).
- Completed Intermediate from Government junior college, kurupam, Vizianagaram district. (1997-1999).
- Completed SSC from T.W.A.H School R.B. Puram. (1996).
Insurance Certification :
- Pursuing Licentiate from Insurance Institute of India.
AREAS OF EXPERTISE :
- Around 3 Years of Techno - Functional experience in Health Insurance Domain.
- A keen analyst with skills in assessing market trends and implementing operational strategies.
- Effective relationship management with Corporate Hospitals and Government Hospitals and interact with doctors and hospitals management.
- Experienced in Implementing procedures, control systems, service standards and operational policies.
- Strong Analytical and Problem Solving skills, Multi-Tasking abilities, with proven experience in utilizing people and process knowledge to assist enterprises in making critical decisions.
PROFESSIONAL EXPERIENCE :
Aarogyasri project from July’16 2008 to till date
Asst.Manager (Claims Department)
From STAR HEALTH AND ALLIED INSURANCE COMPANY.
Aarogyasri Health Care Trust is a unique Community Health Insurance Scheme being implemented in Andhra Pradesh from 1st April, 2007. The scheme provides financial protection to families living below poverty line upto Rs.2lakhs in a year for the treatment of serious ailments requiring hospitalization and surgery. 938 procedures are covered under the scheme.
Roles and Responsibilities :
- Playing a vital role in Claims Departments as a Assistant Manager reporting to General Manager.
- To manage the functional flow of mediclaims till payments or repudiation of claims.
- Finding the fraud claim in settlements, resolving various issues related to claim settlement and grievance queries forward to GM.
- Calculated insurance coverage amounts and determined the appropriate schedule, eligibility, and payments amount.
- Submitting the required reports (doctors & executives claims usage reports, hospital wise pending claims analysis, category wise claims status) to the G.M claims on daily basis.
- Preparing spread sheets in MS-Excel with using tools of pivot table, filter, sort & vlookup etc.
- Coordinating with Doctors and Network hospitals on issues related to Medical documents, non-medical documents & Pending cases.
- Supervising Executives on processing of claims, arranging their duty shifts and Analyzing reports raised by them.
- Giving training to new executives about work flow of Claims Department.
- Supporting & coordinating with Medical team. (Panel of doctors).
MAJOR COURSES STUDIED IN PGDIRM :
- Life Insurance
- General Insurance
- Marketing
- Financial services
PROJECT WORK
- Project done in TPA “MD INDIA HEALTH CARE SERVICES”
PROJECT SUMMARY :
Under took project work in a leading Third Party Administrator, to study various insurance companies in aspects of
- Health polices
- Customer support
- Claim settlement procedures.
STRENGTHS :
- Good problem solving skills
- Ability to handle difficult situations.
- Curious to learn new things
- Willingness to work in a team.
- Quick learner
TECHNICAL SKILLS :
1. Packages : MS-Office
2. Operating Systems : Windows 2007, XP
ACHIEVEMENTS
- Topper in School in SSC.
- Actively participated and organized ‘Insupules-2007’ – a college event ().
- Won prizes in Intra College competitions (1999-2002).

[Guest]

CURRICULAM VITAE
Pawan kumar Dubey
pdpawanwarrior AT gmail.com
CARRIER OBJECTIVE
Seeking a position in an organization to utilize Software skills and that offers professional growth, while being innovative & flexible.
SKILLS
- Language Known : C,C++
- Others : Microsoft Office,java,
html,wml,Sql Server,
Oracle,Visual basic
Qualification
Qualification School/College Board Passing Year Percentage(%)
Matriculation B.I.V, Sec-III/A C.B.S.E 2005 60%
Intermidiate B.S.City College J.A.C 2005-2007 55.6%
BSC.IT Sikkim Manipal
University S.M.U 2007-2010 69.3%
OTHER ACTIVITES & HOBBIES
- Net Surfing
- Listening songs
- Playing cricket
Experience
- 2 years experience in Muskan Hospital & Research Centre as E.S.I Co-Ordinator (Employee State Insuarance Corporation).
Work Profile
1>. This Hospital is in a Tie- Up with ESIC and is only referral hospital
in the District (Bokaro, Jharkhand). My work is to prepare the bills
of the patients by manipulating databases (SQL Server) according
to CGHS Rates.
2>. All the Co-Ordination works on behalf of the Hospital.
3>. IT Works like installing softwares , database corrections, solving
hardware errors,etc.
STRONG POINTS
Devotion towards work, honesty, truth, Ability to work well under pressure, Sharp learning curve, Willingness to pick up new technologies in short span of time.
DECLARATION
I hereby declare that the information provided by me here are true to the best of my knowledge.

Pawan Kumar Dubey

[Guest]

RESUME
Post Applied for—TPA /Claim Executive
*Mr. H. C. Kaushik
Career Objective :
To work with that concern where I can use my skill set and knowledge to serve the organization with my best.
Academic Qualification :
- Passed 10th from Board of School Education, Bhiwani , Haryana.
- Passed 12th from Board of School Education,Bhiwani, Haryana.
- Passed Graduation with B.Com. from Agra University.
- M.B.A. perusing in Healthcare Management.
Professional Qualification :
- Done Diploma in Computer Application of Microsoft office, tally 5.4.
- Trained in TPA processing system from Medvarsty Apollo Hospital New Delhi.
- Insurance adviser of Instant Healthcare Pvt. Ltd. New Delhi.
Work Experience :

- Two years experience with Janak Hospital at Kheri Road Old Faridabad as a TPA executive.
- At present working with Geeta Hospital(GIPSA Impaneled) at Near Huda Market, Sector-28, Faridabad as a Head of TPA Department since November 2006.
Key Skills
- A keen analyst with skills in assessing market trends and implementing operational strategies.
- Effective relationship management with Corporate and hospitals management.
- Experienced in Impanel procedures, control systems, service standards and operational policies.
- Experienced Pre authorizations process, OPD & IPD Billing with the Discharge summary by Software,IPD record reconciliation as per final document.
- Able to Reconciliation or investigation of OPD & IPD case papers from sub departments (Lab,X-Ray,USG, Dispensary,CT,IPD Register) as per case summary and policy terms & conditions.

[Guest]

CURRICULAM VITAE
Career Objective
To make best use of my skills, talent and work with enthusiasm. I look forward to learn and to master the professional skills from well-esteemed company.
About Me
Name RENU Contact Details
Primary e-mail renu.nirman AT gmail.com
Alternate e-mail (Optional) renupaarth AT gmail.com
Knowledge of General insurance - :
- Fire Insurance (Tariff, Discounting, Categorization of Industries, Add on covers) & Burglary Insurance.
- Mediclaim and Group Medicalim (Calculation of GMED, Add of Covers like maternity, pre exsisting corporate floater and etc. Claim settelments with TPA )
- Motor Insurance ( Tariff ,NCB, Discount, Claims )
- Marine Insurance (Open cover & Inland Policy, excess , declarations.)
- Product Liability Insurance
- Group Personal Accident (Calculation of GPA, Coverage’s) & Claim Settlement.
- Issue Cover note regarding all type of General Insurance.
- Workmen Compensation Insurance / Travel Insurance /Householder Policy/Money Insurance / All risk Insurance/Public Liability Insurance/Machinery Breakdown Insurance.
Organization
Duration
Siddhartha Public School (Shahdara)
From 2002 to 2004
M/s Hindustan Insurance Brokers Ltd From To

Aug - 2008
Till date
Job Profile
I start my official carrier with HIBL , it is my Second job and I am here form Aug- 2008
- Follow up all the Renewals
- Co-Ordinate with the Bussiness Associates
- Co-Ordinate with all the existing clients and Sort out there Insurance related problems.
- Co-ordinate with TPA’s and Surveyor’s regarding the claims
- Making Quotation for all kind of projects and follows the Quote from starting to clsosing.
- Co-ordinate with insurance company’s for taking the Minimum Rates and Maximum Discounts, follow up there principles, there underwitin consepts.
- Resolve all the problems regarding claims & other things
- Generating all types of MIS Reports for Delhi Branch
- Maintained Office Administration and Set-up
- Supervise all the Addmin , Marking and Other staff
- Preparing the salary.
- Supervised the policy feeding in company software.
- Co-ordinate with Insurance Co. For Brokerage. And follow up pending brokerage.
Educational Qualifications
Degree & Institute / University
Year of Passing
Additional Certifications Computer Operator & Basic Knowledge of Tally 7.2 ( 3 Month ) 2008
Graduation
B.Com (Delhi University) 2005
S.S.C
C.B.S.E 2002
H.S.C C.B.S.E 2000
Additional Information
Current compensation Rs.
2.20 Lac. per annum
The motivation for a change-- Having been accelerated by a strong urge and driving force to attain thorough professionalism and humanism I would like to take up one of the best possible career opportunities through any esteemed organization .My profile is tendered in the appended sheet and IF Given an opportunity, I will shoulder my responsibities to the best of my efficiency and hard work to achieve individual, group and organizational objectives.
Description of my ideal company :
A company that empowers its employees, and has an open door management policy. A company, which could enhance its employee’s potentialities and give a place to grow.
SKILLS :
- Elementary Computers skills - Ms Office,M.S. Excel, Internet
- Ability to teach myself difficult material, regardless of the subject
- Hard Working and Very Good team worker and know to how to handle the team.
- Go-getter with a practical approach.
- Responsible and Determinate.
- Ability to work in Pressure and stress

[Guest]

Pradeep G
E Mail : pradeepgokul AT gmail.com

CAREER OBJECTIVE
To obtain a position as a team-player in a people-oriented organization where I can maximize my customer-service experience in a challenging environment to achieve the corporate goals.

WORK EXPERIENCE
Ø Sri Balaji Hospital Pvt Ltd
As Front Office Executive cum Insurance Coordinator, From June 2011 to Till Date
Ø TTK Healthcare TPA Pvt Ltd. (Third Party Administration)
As Team Leader in Claims (Citibank) Department, since Oct’2010- Feb 2011.
As Senior Executive in Cashless (Preauthorization) Department, Since July’06-Oct‘2010
Ø ZDS (Zen Data Services E-Publishing)
As Junior Processor in Image Editing, From March 2005 to July 2006
Ø DCS BPO (Data Consultancy Services)
As Process Executive, From Jan 2005 – Feb 2005
Key Role in Sri Balaji Hospital : (June 2011 – Till Date)
Ø Handling TPA coordinators, Insurance people regarding the admission of the patients in our Hospital for cashless purpose.
Ø Handling Out patients by giving appointments to various specialist doctor’s for consultation purpose.
Ø Handling internal and external calls for giving appointments, booking blood from blood banks,etc
Ø Handling Billing and cash for investigation and consultation of out patients.
Key Role in TTK Cashless Dept : (July 2006 – October 2010)
Ø Giving Training to New Doctors and Executives for handling the Software tool.
Ø Giving Training to New Executives regarding Policy Conditions and Coverage’s.
Ø Handling Customers, Hospital coordinators, Insurance people, Brokers over phone by clearing the queries regarding the admission of their clients in Hospitals for cashless purpose.
Ø Clearing Non Id files by coordinating with Claims and Enrolment Department.
Ø Coordinating with Other branches all over India regarding the admissions of their Patients in the Hospital.
Key Role in TTK Claims Dept : (October 2010 – February 2011)
Ø Clearing Doubt’s for Executives regarding claims received from hospitals and customers.
Ø Handlings mails by replying to customers, other branch co-coordinators, insurances etc.
Ø Getting opinions from insurance for late submission and rejection claims.
Ø Reviewing on Network shortfalls and Member shortfalls on weekly basis.
Ø Quality control over the approvals done by executives on daily basis and doing above limit approval.
ACADEMIC PERFORMANCE
Ø Master of Business administration (MBA) in Human Resources Management
Anna University, Centre for Distance Education
Passed out in 2009 with aggregate of 67%
Ø Bachelor of Science (B.Sc.) in Visual Communication
Sindhi College, University of Madras
Passed out in 2004 with Aggregate 62%
Ø HSLC with Aggregate 67% in 2001
JG Hindu Vidyalaya
Tamil Nadu State Board
Ø SSLC with Aggregate 78% in 1999
JG Hindu Vidyalaya
Tamil Nadu Matriculation Board
COMPUTER QUALIFICATION
Ø Advanced Diploma in Computer Application(ADCA)
(C, C++, VB project & seminar), Indian Institute of Computer Education
Ø Diploma in Multimedia
Adobe Illustrator & Morphing
Ø Diploma in Desktop Publishing
Adobe PageMaker
TECHNICAL SKILLS
Ø Multimedia Software’s :
Adobe Photoshop 7.0, Adobe Illustrator 10, Adobe PageMaker 6.5, Adobe Acrobat 5.0,
Abby Fine reader, Epsilon 10, Macromedia Flash MX, CorelDraw 10
Ø Microsoft Office [ 9x, XP ]
Ø Operating System : Microsoft Windows [ 9x, XP]
PERSONAL STRENGTHS
Ø Team Player - Capable of working in a team, with people at all levels.
Ø Hard - Smart Working.
Ø People Handling Skills.
Ø Capable of Adjusting to any environment.
Ø Quick adaptability to new technologies.
EXTRA CURRICULAR ACTIVITIES
Ø Ball Badminton Player
Played for Sindhi College during 2002 – 2003
Played for JGHV during 1997 – 2001

[Guest]

Family policy for 2 lakhs: My age is 43, my wife is 42,elder son is 16,younger son is 11. What is the amount and what are the policy coverage?

[Guest]

What is the address of good health plan in Chennai?