1. CURRICULAM VITAE
KAMAL GOHAR
Primary Add: H.No. 9683/10
DBG Road, Pahar Ganj
New Delhi - 110 055
Secondary Add: H. No.3710A/5
Jawahar Colony, Faridabad,
Ph: 9910311156, 9810141955
E-mail: krajput81@gmail.com
Objective
Seeking a challenging position in an organization, that will provide adequate opportunities and environment to help
explore my knowledge, experience and clear strengths to mutual benefits.
Career Highlights
Organization : Pacific BPO Pvt. Ltd.
Designation : Team Leader (Revenue Cycle Management)
Period : Dec.2015 to Till Date
Joined Pacific as a Team Leader in December 2015 and have been actively involved in different projects, tasks &
initiatives. Currently handling a team size of 25 Agents.
Job Responsibility
 Manage a Team Size of 25 FTEs for Revenue Cycle Management (Provider Billing)
 Organize resources for effective execution of operation plans.
 Use resources to optimum level for achieving targets and productivity.
 Co-ordinate with Clients and take appropriate decisions regarding operations.
 Maintaining leave planner according to the need of the process.
 Satisfying client and company needs by implementing desired projects.
 Take proper initiatives to strengthen the team to achieve higher targets and enhance the productivity.
 Maintaining Quality standard of the work.
 Appraise the performance of the team members at the regular intervals
 Provide assistance to all the team members for their daily work.
 Regular interaction with client via phone and e-mails.
 Discussing problem list cases for every provider group with client
 Generating secondary insurance claims on HCFA
 Quality check of daily production (sample size) for AR & Billing team.
 Identify and correct the billing errors on patient accounts.
 Identify trends for areas of improvement, efficiency in claims handling.
 Follow HIPAA compliance while working on patient accounts.
 Monitoring the work & identify training needs for team members
 Production & Quality report for MIS.
 Invoice & download details for billing team.
 Transaction details for billing team
 Weekly meeting with quality dept.
 Meeting with management, discussing the areas where team is lacking & advising the most appropriate step
which can be taken to improve the teams skills, production & quality
 Effectively involved in employee engagement exercises to bring down the attrition to minimal level,
providing quality and disciplined work place
 Tracking and maintaining records for a variety of data includes Productivity, updates, new learning &
errors

2.  Chairing Team meetings, focusing on issues like schedule efficiencies, team and individual performances
 Conduct regular One-on-One, Focus Groups with the floor to resolve all people issues
Organization : UNITEDHEALTH GROUP
Designation : Management Trainee (Supervisor)
Period : June 2007 to Dec. 2014
Joined UHG as a Sr. Claim Associate (US Health Insurance) in June 2007 and then eventually got promoted to
Subject Matter Expert and then to Management Trainee and have been actively involved in different projects, tasks
& initiatives. Handled a team size of 30 FTEs.
Job Responsibility
 Manage complete cycle of Customer Insurance Policies and work with different departments (Sales,
Implementation, Installation, Claim Testing, Claim Payment and Rework) for smooth completion of
Benefits Implementation.
 Responsible for managing operations & leading teams for excelling business targets & service delivery
metrics.
 Lead Quality Review with all the Departments such as Client & Senior Management
 Work with Training Dept. to lead compressive action plan to improve Quality
 Identify and Lead process improvement initiative that drives business values
 Draw action plan as per the Error Analysis and Implement the same
 Effective use of different quality tools to find various ways for Process Improvement
 Plan and coordinate resources for new accounts
 Review performance of different processes regularly with the team and with Ops leaders
 Review System set up, Product and Error Analysis to find out the opportunity of Automation Project
 Conceiving/Implementing short/long term plans for achievement or process objective.
 Involved in organizing various employee engagement activities in coordination with HR, Training,
Operations and Quality Team.
 Interacting constantly with the client with regard to various aspects such as staffing & scheduling
requirements, Inventory management performance reporting etc
 Preparing & compiling various weekly/monthly reports pertaining to process quality and productivity.
 Managing workload allocation, capacity utilization, report analysis & TAT analysis.
 Queue Monitoring and work allocation based on the client SLA.
 Handle the team of Process and adjudicate claims (hospital and medical) which are dropped by Automatic
Claims Adjudicate system for manual intervention
 Effectively involved in employee engagement exercises to bring down the attrition to minimal level,
providing quality and disciplined work place
 Tracking and maintaining records for a variety of data includes Productivity, updates, new learning &
errors
 Chairing Team meetings, focusing on issues like schedule efficiencies, team and individual performances
 Conduct regular One-on-One, Focus Groups with the floor to resolve all people issues
Projects Handled
 Trained 7 Training Batches with 250+ Agents for India and along with that Trained 2 batches over the
WebEx for Philippines Site.
 Worked for TOPS Automation Project to reduce 15minutes per case which has altogether done the savings
of $1.5 million
 Worked with Automation Team and created a macro to streamline the Remark Code Process and made the
savings of $37k.
 Worked with Onshore Partners and streamline the Process Related Materials (P&P, Updates & Process
Flow)
 Worked on Catch up List Project (to complete the policy updates which are left at the time of renewal of
existing policies and New Policies) and successfully completed
 Worked on BAR Approval Project (some non standard benefits for which customer has to sign an

3. agreement for Manual Intervention) and successfully completed
 Worked on Policy Update Log Project (Log wherein all the changes done on a particular policy should be
updated) and successfully completed
Initiatives
I'm a core team member for several organizational Initiatives.
 Ucare Team (Corporate Social Responsibility)
An Initiative by Organization to support under privileged human beings wherein we conduct several events
to help them groom in their lives. Some of the big successful events are Friendship Classes, Wish Tree
Campaign, United Giving Campaign, Blood Donation camps etc.
 UFL Team (United Fun League)
An employee engagement forum, wherein we conduct several activities for Employee Engagement Some
of the big successful events are Fashion Show, Photo Exhibition, UFL Got Talent, Dance competition etc.
 USC Team (United Sports Committee)
A forum to conduct various Sports events. Some of the big successful events are United Premiere League
Cricket Tournament, Table Tennis Tournament, Pool Table Tournament, Directors Cup Cricket Tournament
etc.
 Live Well (Our People First)
Live well is a platform where we help all the employees to live healthy lives. Some of the big events are
Health Checkups, Airtel Delhi Half Marathon, Blood Donation Camps, H1N1 vaccination camp etc.
Key Achievements
 I was awarded with Above & Beyond Award 4 times for my exceptional work towards Organizational
Initiatives
 Awarded as best Trainer (Talent Champion Award) for training 3 successful Training Batches.
 Saved $1.5 Million from Automation Project and appreciated by Vice President.
 I was awarded as a STAR OF THE MONTH for many months.
 My Team was awarded "Best Team of Quarter" for Quarter - 1, 2008.
 My Team was awarded "Best Team of Quarter" for Quarter - 3, 2009.
 I was a part of "Best Team of the Year" for the Year 2008.
 Trained on Six Sigma White Belt.
 Trained on Six Sigma Yellow Belt.
 Trained on LeAn Concept.
Organization : GLOBERIAN PVT. INDIA LTD
Designation : Mentor (Asst. TL-Revenue Cycle Management)
Period : Nov. 2005 to June 2007
Joined Globerian as an Associate (Medical Billing) in Nov. 2005 and then eventually got promoted to Mentor and
have been actively involved in different projects, tasks & initiatives. Handled a Team size of 20 individuals.
Job Responsibility
 Assist Team manager to draw action plan, implement and review.
 Organize resources for effective execution of operation plans.
 Use resources to optimum level for achieving targets and productivity.
 Co-ordinate with Clients and take an appropriate decisions regarding operations.
 Maintaining leave planner according to the need of the process.
 Satisfying client and company needs by implementing desired projects.
 Take proper initiatives to strengthen the team to achieve higher targets and enhance the productivity.
 Maintaining Quality standard of the work.
 Appraise the performance of the team members at the regular intervals
 Provide assistance to all the team members for their daily work.

4.  Regular interaction with client via phone and e-mails.
 Discussing problem list cases for every provider group with client
 Generating secondary insurance claims on HCFA
 Quality check of daily production (sample size) for AR & Billing team.
 Identify and correct the billing errors on patient accounts.
 Identify trends for areas of improvement, efficiency in claims handling.
 Follow HIPAA compliance while working on patient accounts.
 Monitoring the work & identify training needs for team members
 Production & Quality report for MIS.
 Invoice & download details for billing team.
 Transaction details for billing team
 Weekly meeting with quality dept.
 Meeting with management, discussing the areas where team is lacking & advising the most appropriate step
which can be taken to improve the teams skills, production & quality
Key Achievements
 I had joined Globerian as a Billing Executive and promoted as a Mentor (Asst. Team Lead) just after
completing 9months as a Billing Executive in the Production.
 For providing exceptional contribution towards the Customer Satisfaction, Quality, Production and Turn
around Time and selected to work for three different process.
 Rewarded as a STAR PERFORMER for consecutive 5months (June'06 to Oct.'06).
Educational Qualifications
 B.com (p) from Delhi University
 Diploma in computer applications from RCC computer center
Personal Profile
Father's Name : Mr. Ashok Kumar
Date of Birth : 01 Jan.1981
Marital Status : Married
Language Known : English, Hindi.
Declaration
I hereby certify that the above information is true to the best my knowledge.
Place: New Delhi
Date: Kamal Gohar