Open to opportunities

Amit Singh

@amitsingh30

US accident claims specialist owning verification, benefits adjudication, and denial workflows with Wynsure, PEGA, and Xcelys.

India

Message

What I'm looking for

I’m aiming for a Team Leader/SME role where I can drive claims processing quality and onboarding—using my cross-platform experience, claims accuracy, discrepancy resolution, and hands-on training to support faster ramp-up and consistent standards.

I handle the end-to-end lifecycle of US accident insurance claims at EXL Service (Aflac), using Wynsure and PEGA to verify benefits, secure pre-authorizations, and adjudicate payouts within Aflac policy terms and defined TAT.

I also manage HIPAA-compliant records while reviewing EOB/ERA details, coordinating benefits (COB), resolving submission discrepancies, and supporting denial management. I’ve trained 27+ new joiners on claims workflows and platform navigation, and I bring a data-analytics background from a Post Graduate Diploma in Data Analytics to improve claims quality and reporting.

Experience

Work history, roles, and key accomplishments

Current

US Accident Claims Specialist

Current

EXL Service

Jul 2024 - Present (2 years 1 month)

Processed end-to-end lifecycle of US accident insurance claims on Wynsure and PEGA, verifying benefits and adjudicating payouts in compliance with Aflac guidelines. Delivered process training to 27+ new joiners on claims workflows and platform navigation.

Wynsure PEGA Insurance Verification FNOL HIPAA ICD 10 CPT Denial Management Claims Processing Training

Process Associate — US Healthcare

Capgemini

Sep 2023 - Jun 2024 (9 months)

Performed insurance verifications for US patients, validated coverage, obtained prior authorizations, and managed HIPAA-compliant EMRs in Xcelys. Supported denial management and coordination of benefits to reduce claim rejections.

Insurance Verification Prior Authorizations Denial Management HIPAA EMR ICD 10 CPT