Pragati Nayan Lohiya

Experience

1. Resolving Analyst

   Optum

   Oct 2016 — Present · Gurugram, IN

   Reviewing, investigating, and reporting money laundering cases Providing ongoing monitoring and resolving Remote, India Service complaints Dealing appropriately with consent refusals following SAR submissions Acting as a point of contact for law enforcement agencies in ongoing criminal investigations that commenced from a submitted SAR Cooperating with other teams in providing professional and efficient front-line compliance support and seeking to improve the company\'s processes.Maintaining records of customer identification information/KYC including name, address, date of birth, social security number, place of birth, and any other identifying information To keep track of outstanding balance concerning the date of service, date of filing the claim, amount billed To follow up with the insurance company for the delay in the payment and to sort out the reason for the delay Validated results and performed quality assurance to assess the accuracy of data To analyze the data by following the agent reports. To handle the denial record by analyzing the EOB, and correspondence To analyze the claims depending on the claim status.Transaction processing and making reach-out to Insured/provider/facility according to standard work & SOP.Prioritize transactions according to detailed guidelines to meet SLA.Plans and prioritizes tasks and work responsibilities to achieve objectives.Comprehending and responding to customer inquiries. Identify, research, and resolve problems.Interact with Onshore /Offshore and customers in a supportive and professional manner via email and on calls.Handle own work in process and support team efforts to ensure that individual and team goals are met.Maintain key records like working files, and email for reference and audit purposes.Ensure that turnaround time and quality of the work meets Company service standards.

Education

• MDRLV College

  12th

  2007 — 2009

• Rajiv Gandhi Prodyogiki Vishwavidyalaya

  Bachelor of Engineering - BE

  2009 — 2013

• Arvind High School

  10th

  2006 — 2007