SC

Open to opportunities

Sajan Chhetri

@sajanchhetri1

Healthcare claims and IT support professional with 8+ years at TCS.

What I'm looking for

I’m looking for a role where I can process and adjudicate claims/denials, keep HIPAA-compliant data security, support customers via chat, and ensure SLA/TAT accuracy with strong quality and incident management.

I’m a Senior Associate with 8+ years at Tata Consultancy Services (TCS), including 6+ years in US Healthcare Claims Processing and IT Support. I focus on claims adjudication, EOB/denial analysis, and strict HIPAA compliance while following payer guidelines such as Aetna, Cigna, UHC, and Kaiser.

I’ve processed and adjudicated medical insurance claims according to payer policies, reviewed EOBs, and resolved denied or rejected claims by coordinating with onshore teams for complex issue resolution. Currently, I’m working in UK Pension services where I handle customer queries and chat support, perform benefit calculations, and manage death/survivor claims.

Alongside domain work, I provide L1 IT support—handling incident management, ticket resolution, SLA & TAT monitoring, and application/data support with tools like ticketing and CRM systems. I’m proud of awards including the BPS Star Performance Award and Services Commitment Award, and I bring a consistent commitment to data security, accuracy, and fast customer outcomes.

Experience

Work history, roles, and key accomplishments

TS

Current

UK Pension Claims & Benefits Support

Current

Tata Consultancy Services

Handle UK pension customer queries through chat, including policy explanation and pension benefit calculations. Support death and survivor claims while maintaining data security and accuracy.

UK Pension Operations Chat Support Death And Survivor Claims Claims Processing

TS

L1 IT Production Support (Truist)

Tata Consultancy Services

Jun 2024 - Dec 2024 (6 months)

Provided L1 production support via voice and chat, handling incident management and ticket resolution while meeting SLA targets. Identified customer/account-related errors, updated records, and ensured timely application support using ticketing and CRM tools.

L1 IT Support Incident Management Ticketing CRM Tools Application Support Chat Support Data Analysis

TS

Insurance Process Associate (EOB)

Tata Consultancy Services

Mar 2024 - Jun 2024 (3 months)

Performed EOB analysis and quality checks while supporting insurance/mortgage processing requirements through customer chat support. Reviewed loan documents (income, credit, and property details) and ensured compliance with US mortgage guidelines.

US Mortgage Guideline Compliance Chat Support Denial Exception Support

TS

US Healthcare Claims Associate

Tata Consultancy Services

Jan 2018 - Mar 2024 (6 years 2 months)

Processed and adjudicated medical insurance claims according to payer policies, reviewing EOBs and resolving denied or rejected claims. Maintained 100% adherence to HIPAA data security standards and coordinated with onshore teams for complex issue resolution.

HIPAA compliance Quality Assurance Data Security

Education

Degrees, certifications, and relevant coursework

BC

Baharat Kartik oraon Hindi gov college

Bachelor of Arts, Arts

Completed a B.A. degree (passed) in 2017 from Baharat Kartik oraon Hindi gov college.

MS

Mahavir Hindi High School

12th Grade, General Education

Completed 12th grade in 2014 at Mahavir Hindi High School.

MS

Mahavir Hindi High School

10th Grade, General Education

Completed 10th grade in 2012 at Mahavir Hindi High School.

Tech stack

Software and tools used professionally

Gmail

Jan

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