Swatantra Pal
Appeals Representative Associate | Healthcare Operations | Optum
- Role
- Appleas at Optum
- Location
- Gurugram, HR, IN
- LinkedIn followers
- 500 followers
About Swatantra Pal
Detail-oriented and analytical MIS Executive with expertise in data analysis, reporting, and business intelligence. Skilled in leveraging advanced Excel functions such as VLOOKUP, HLOOKUP, Pivot Tables, SUMIFS, COUNTIFS, and Power Query to transform raw data into actionable insights. Proficient in Google Sheets, Basic SQL, and Power BI for dynamic reporting and data visualization.With a strong foundation in data management and automation, I streamline processes, enhance decision-making, and support business operations with accurate, data-driven solutions. Always eager to optimize workflows and improve efficiency through innovative data strategies.
Experience
Appleas
Dec 2025 — Present · Gurugram, IN
As an Appeals Representative Associate at Optum, I am responsible for reviewing, processing, and resolving healthcare appeals in accordance with company policies and regulatory guidelines. I analyze medical records, claims, and supporting documentation to ensure accurate and timely appeal decisions. I collaborate with internal teams and follow compliance standards to deliver quality service and support member satisfaction.Key Responsibilities:Review and process member and provider appealsAnalyze claims, medical documents, and supporting recordsEnsure compliance with healthcare regulations and company policiesMaintain accurate documentation and case recordsMeet productivity and quality standardsCommunicate effectively with internal teams
Education
Chatrapati Sahuji Maharaj Kanpur University, Kanpur
Bsc, Biology, General
2021
Chatrapati Sahuji Maharaj Kanpur University, Kanpur
Bsc, Accounting
Chhatrapati Shivaji Maharaj University
Bachelor's Degree
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