Pankaj Bisht

I am aspiring to secure a challenging position in a corporate environment where my qualifications and skills can be fully utilized, providing me with opportunities to grow professionally

Quality Auditor - IRS Pvt. Ltd.

(2020-10)

• Audited professional and hospital claims processed by team members to ensure accuracy, compliance with payer guidelines, and adherence to U.S. healthcare billing standards
• Identified errors and compliance gaps in claims, providing actionable feedback to improve quality and reduce rework.
• Collaborated with team members to resolve day-to-day queries and operational challenges, ensuring smooth claim processing.
• Assisted in developing corrective action plans and conducted feedback sessions to enhance team performance.
• Ensured adherence to SOPs and contributed to process improvements to strengthen audit controls
• Supported training and mentoring initiatives to improve overall team productivity and accuracy.

AR & SME - I Health Pvt. Ltd.

(2015-04 - 2020-02)

• Processed professional and hospital claims across multiple levels, ensuring compliance with U.S. healthcare billing standards.
• Identified and resolved claim errors, submitting corrected claims with required documentation to insurance companies.
• Played an active role in process transitions, collaborating with internal teams and clients to ensure smooth implementation.
• Trained and mentored new hires on U.S. healthcare processes and revenue cycle workflows.
• Managed end-to-end Revenue Cycle Management (RCM), including claims processing, follow-ups, and resolution.
• Coordinated with insurance representatives to verify policies, resolve discrepancies, and submit supporting documentation.
• Developed Standard Operating Procedures (SOPs) and created PowerPoint presentations for process training and documentation.
• Prepared and shared weekly and monthly performance reports with management.

Bachelor of Commerce - Delhi University

Senior Secondary - Punjab C.B.S.E Board

Matriculation - C.B.S.E Board