1. RESUME
Surender Kumar
House No. 10
Gali No. 3, Acharyapuri,
Near Bus Stand
Gurgaon-122001
Mobile: - +918285502636,
E-mail: surenderhooda16@gmail.com; surenderhooda_2048@yahoo.in
Career Objective:
To acquire the position of a insurance claims investigator and assist the organization in
verifying the authenticity of insurance claims and estimating the amount payable for
insurance.
Key Skills:
 Proficient with the insurance procedures, regulations and investigation methods.
 Exemplary investigative and observational skills that help detect frauds quickly.
 Capability of drafting reports and presenting vital information comprehensively.
 Ability to converse and coordinate activities with clients to maintain regularity.
 Excellent observation, communication and investigation skills.
 Comfortable collaborating with internal departments and external agencies, able to
work without supervision, strong eye for detail, able to negotiate, capable of working
as a team player.
Academic:
Degree University/Board Year of passing Grade
M.B.A SMU Jan-2011 First
B.Com MDU June-2008 Second
S.S.C BSEH April-2004 Second
H.S.C BSEH April-2001 First
Computing Knowledge:
 Good Knowledge of Internet Stuff.
 Knowledge of Windows & MS – Office.
 Able to create spreadsheets and reports, comfortable with claims investigations software
and familiar with electronic health records.
Professional Profile:
 Thorough knowledge of computers.
 Face-up to demanding situations with ease.
 Proven ability to work under pressure as a team and achieve tight deadlines.
 Well versed with very rich MS-EXCEL skills like Pivot tables, Logical functions, V&H
Lookup, Array & IF functions. Good in Excel shortcut key & General Formula.

2. Professional Experience:
Max Bupa Health Insurance Private Limited
Sr. Executive (Fraud & Investigator) 03rd
Sep‘13– Current
 Responsible for investigate claims (cashless & reimbursements), scrutiny of cases,
make a checklist and questionnaire for customer and doctor.
 Perform investigations for the organization and check the authenticity of the
insurance claims made by the policy holders.
 Inspect the documents and verify the personal and financial records of the
insurance claimants and check for accuracy
 Communicate with the policy holders or witnesses and visit sites to confirm the
occurrence of the event and check for any intentional actions
 Take legal actions against the fraudulent individuals
 Perform close surveillance on the claimant to evaluate the possibilities for frauds
 Analyzed information collected from field investigations.
 Conducted field investigations and initiated appropriate surveillance activities.
 Managed an investigation in progress until the case has been closed and
recommended additional steps to secure necessary background information.
 Provided updated reports on progress of investigations and recommendations for
further actions.
 Evaluated data and information to identify cases of potential fraud, abuse and
wastage.
 Compiled summary of investigative steps, findings and suggestions.
CPP Assistance Services Private Limited
Sr. MIS Executive (Central MIS) 11th
Mar‘10 – 02nd
Sept’13
 Responsible for preparing MIS Report of Customer Service Business Unit & HR Dept.
 Generation of Daily/Weekly/Monthly Excel reports and validating the reports as per
requirements.
 Need to maintain Daily Reports For Business Partner Banks
• Like BTD, YTD, MTD, Daily reports etc.
• Maintain daily collection, cancellation, bank curing etc.
• Verify MPA Payment and Refund file.
• Maintain commission file for all business partners.
• Maintain daily sales file and sales MIS Reports.
• Maintain data for Call Centre.
• Maintain data for business partners for curing monthly basis.

3. • Taking Backup Regularly/periodically.
 Need to update & maintain in house Software (NPP & MPA Bank) on Daily, Weekly &
Monthly basis.
 Verification of Profile need to done before updating.
• Need to update selected candidates information in Incubation Tracker & also need
to update the HR related information on a weekly basis
• Like Personal Details, last Employers Details, Education Detail, Selected Process
Information with their respective test, Scores.
• Also need to update Candidates attendance details with their Actual DOJ, Employee
codes, Induction Attendance & batch movement as per selection of candidates on a
weekly basis.
• Need to do Redeployment from one batch to other batch Process DOJ in incubation.
 In Absence of Call Centre person need to handle Call Centre activities like
• Managing data for Call Centre.
• Updating MIS reports for Call Centre Approvals.
• Inductor feedback daily curing status.
• Updating training calendar for that week batches.
• Updating Incentives and login status for that week batches.
 Consistent Development on New Reports as per Business Alignment.
Aegis BPO Services Private Limited.
Customer Care Executive Dec.08 – Dec.09 (12 Months)
 Need to handle customer’s problem and queries. Make our customer completely satisfy.
 Updating different types of reports & need to updating information into system.
 Need to achieve all the targets of Team.
PERSONAL INFORMATION:
Father’s Name : Sh. Randhir Singh
Date of Birth : Feb 10, 1986
Marital Status : Unmarried
Languages Known : English, Hindi
Interests : Music, Sports, Reading & Traveling.
Nationality : Indian
Date
Place
(SURENDER KUMAR)