Open to opportunities

Simran Shaik

@simranshaik

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I am an experienced medical officer skilled in claims review and patient care.

India

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What I'm looking for

I seek a collaborative role that combines clinical practice and TPA/claims review, with growth in pharmacovigilance and research, and opportunities to improve patient outcomes.

I am a Medical Officer with experience in clinical care and third-party administration (TPA) medical review. I have served as a duty doctor in a super speciality hospital and currently work on claim review and insurance coverage assessment at a healthcare TPA.

My responsibilities have included review claims, determine coverage, calculate claim amounts, and process payments, alongside data management and pharmacovigilance process tasks. I have participated in ward rounds, medical records review, patient counseling, and ENT-related surgeries.

I completed a Pharm.D. and conducted a study on meconium stained amniotic fluid and meconium aspiration syndrome, focusing on risk factors and outcomes in newborns. I bring strong problem-solving and decision-making skills and am eager to continue learning new medical technologies and methodologies.

Experience

Work history, roles, and key accomplishments

Current

Medical Officer

Current

Medi Assist

Aug 2024 - Present (1 year 1 month)

Reviewed medical claims, verified patient information and documentation, determined coverage per regulations, calculated reimbursements, and processed payments to policyholders to ensure accurate benefit administration.

Coverage Determination Claims Processing Data Management Regulatory Compliance

Duty Doctor

Vijaya Super Speciality Hospital

May 2021 - Feb 2024 (2 years 9 months)

Conducted ward rounds, reviewed medical records, provided patient counselling, and assisted in ENT-related surgeries at a super speciality hospital to support clinical care delivery.

Medical Records Review Ward Rounds Patient Counseling ENT Surgery Assistance Clinical Assessment

Education

Degrees, certifications, and relevant coursework

Jawaharlal Nehru Technological University, Anantapur

Doctor of Pharmacy, Pharmacy

2015 - 2021

Activities and societies: Capstone project (07/2019–12/2019): Study of meconium-stained amniotic fluid and meconium aspiration syndrome; analyzed risk factors and neonatal outcomes. Location: Nellore.

Completed a Doctor of Pharmacy (Pharm.D) program at Jawaharlal Nehru Technological University, Anantapur from Oct 2015 to May 2021, including a capstone study on meconium-stained amniotic fluid and meconium aspiration syndrome.