Dr. Riya Mittal

A dedicated healthcare management professional with experience in underwriting processes, financial analysis, and healthcare operations. Proficient in risk assessment, and process optimization to enhance quality and turnaround time (TAT). Seeking a managerial role where I can leverage my expertise in underwriting decision-making, business process improvements, and IT system development to drive operational excellence.

CASHLESS CLAIM MANAGER - CARE HEALTH INSURANCE

(2026-01)

• Pre-authorization Management: Processed end-to-end cashless requests for planned and emergency admissions within strict TAT.
• Medical Adjudication: Reviewed clinical documents and ICD/CPT codes to determine medical necessity and policy admissibility
• Hospital Liaison: Coordinated with network provider desks to resolve documentation queries and expedite patient discharges.
• Claim Settlement: Audited final bills and discharge summaries to ensure accurate payouts and minimize non-medical leakages.

IPD EXECUTIVE - NARAYANA MULTISPECIALITY HOSPITAL

(2025-01 - 2025-12)

• Coordinated daily floor operations to ensure smooth patient flow and efficient service delivery.
• Oversaw admission, discharge, and transfer processes while ensuring proper documentation for insurance and billing purposes.
• Gained hands-on experience in cashless hospitalization workflows, TPA coordination, and claim form documentation.

OPERATION INTERN - BLK MAX HOSPITAL DELHI - Delhi

(2024-05 - 2024-06)

• Analyzed patientservice workflows to identify inefficiencies and recommend process improvements.
• Reviewed quality and turnaround time (TAT) in hospital operations to optimiz efficiency.
• Understood claims management, reimbursement handling and collaborated with IT teams to improve systems and streamline documentation.

PG MBA - Hospital and Health Management - IIHMR University Jaipur (2025)

UG BDS - Rajasthan Dental College and Hospital Jaipur (2022)

XII CBSE - India International School Jaipur (2016)

X RBSE - Royal Alpha Sec School Sawai Madhopur (2014)