Open to opportunities

kush kumar

@kushkumar

Claims Processor specializing in healthcare insurance adjudication, denials resolution, and accurate payer documentation.

India

Message

What I'm looking for

I want to work in healthcare claims processing where I can adjudicate and resolve denials accurately, use payer documentation skills (HCFA/UB), and grow by handling more complex precertification and reimbursement workflows.

I work as a claim processor, focused on “Process adjudication and resolve for payment and Denial claims.” I’ve gained hands-on experience supporting a U.S. health care-based workflow, reviewing and analyzing Healthcare payer claims including “HCFA and UB forms.” I bring practical knowledge of “authorization, COB, duplicate, pricing and corrected claims process,” along with payer concepts like “In Network, Out of-network provider, deductible, coinsurance and co-pay.”

Before this, I completed a “training as a Sales Advisor under Relationship Manager,” where I collected leads, followed up by call, and arranged meetings with potential advisors. With a “B.Com” education and an “O level basic computer course” covering “MS Office- word, excel, power point,” and fundamentals of “C programming language,” I work with a careful, detail-oriented mindset—prioritizing correct coding, documentation, and clear outcomes for every claim.

Experience

Work history, roles, and key accomplishments

Claim Processor

Concentrix Daksh Private Limited

Jan 2024 - Jan 2025 (1 year)

Processed and adjudicated U.S. healthcare payer claims, reviewing HCFA and UB forms and resolving payment and denial issues. Worked with claims concepts including authorization, COB, duplicate, pricing, corrected claims, and provider network and patient responsibility components.

ICD 10 Outpatient Claims Reimbursement Explanation Of Benefits (EOB)Authorization Pricing

Sales Advisor Intern

Prudent Corporate Service Limited

Jan 2019 - Present (7 years 6 months)

Completed a 3-month internship as a Sales Advisor under a Relationship Manager, conducting field outreach to insurance advisors. Collected advisor contact details (leads), followed up by call, and arranged meetings for potential collaboration.

Field Sales Lead Generation Relationship Building Follow up

Education

Degrees, certifications, and relevant coursework

School of Open Learning, Delhi University

Bachelor of Commerce, Commerce

2016 - 2021

Completed a Bachelor of Commerce at the School of Open Learning, University of Delhi. Studied Accounts, Business, Economics, Auditing, and Cost Accounting.

World Class Skill Centre (Singapore and Delhi Govt.)

Finance Executive Course, Finance

2018 - 2019

Completed a Finance Executive course. Covered business etiquette, accounting, banking operations, and capital management/stocking.

National Institute of Electronics and Information Technology (NIELIT)

O Level Basic Computer Course, Computer Science

2016 -

Completed an O Level Basic Computer course covering C programming and MS Office (Word, Excel, PowerPoint). Also covered computer hardware/software fundamentals.