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Tabassum Begum

@tabassumbegum

I manage healthcare prior authorizations, eligibility verification, and compliance for complex oncology and procedural care.

India

Message

What I'm looking for

I'm looking for a healthcare operations role where I can manage prior authorizations and eligibility workflows, maintain compliance and accuracy, and improve coordination between providers, payers, and patients.

I'm currently supporting KPMG Assurance and Consulting LLP's newly established Healthcare GCC, helping drive operational workflows, baseline metrics, and best practices for future teams.

I execute end-to-end eligibility verification across EMR systems and tools including Candid, with a focus on accurate patient and insurance data.

I manage prior authorization workflows for radiation oncology treatments through payer portals including eViCore and Evolent, interpreting NCCN and FDA guidelines for medication oncology requests.

Previously, I handled eligibility, benefits verification, prior authorizations, and provider and payer communication at Inventurus Knowledge Solutions and Sutherland Healthcare Services, supporting inpatient, outpatient, radiological, and surgical procedures using CPT and ICD-10 codes.

Experience

Work history, roles, and key accomplishments

Current

Sr. Associate Collections

Current

KPMG Assurance and Consulting LLP

Nov 2025 - Present (10 months)

Served as a key member of the pilot cohort for KPMG's newly established Healthcare (GCC), driving operational workflows and helping define baseline metrics and best practices. Executed end-to-end Eligibility Verification processes and managed Prior Authorization workflows for complex radiation oncology treatments.

Eligibility Verification Prior Authorizations EMR Systems Candid EviCore Evolent NCCN Guidelines FDA Guidance Documents Healthcare Compliance Data Privacy

EVBV & Prior Authorization

Inventurus Knowledge Solutions

Aug 2025 - Nov 2025 (3 months)

Conducted thorough reviews of insurance policies to determine coverage and eligibility. Verified patient demographics and insurance information to prevent claim denials and authorization submission delays.

Insurance Verification Eligibility Verification Prior Authorizations Communication Skills Record keeping Payer Guidelines

Prior Authorization Representative

Sutherland Healthcare Services

Jan 2022 - Jan 2025 (3 years)

Processed inbound and outbound calls from healthcare providers and patients, addressing inquiries related to prior authorizations. Ensured compliance with managed care standard operating procedures and maintained organized records of prior authorization and medical necessity requests.