---
title: "Gulshin Chauhan - Product Specialist in Gurugram | Tal"
description: "Meet Gulshin Chauhan, process associate based in Gurugram."
image: "https://tal.club/meet/gulshin-chauhan/share-image"
---

# Gulshin Chauhan on Tal

## Headline

process associate

## About

I am a dedicated and detail\-oriented professional with over ,6 years of experience in the Healthcare and Insurance industry, having worked with leading companies like Genpact and UnitedHealth Group \(Optum Global Solutions\)\. My core expertise includes claims processing, policy verification, EOB analysis, and authorization handling within the US healthcare system \(Medicare/Medicaid\)\. I’ve worked extensively with tools like Facets, Citrix, Omega, Power BI, and am well\-versed in ICD10/CPT coding and medical claim reviews\. At Genpact, I processed life insurance claims, conducted document verification, and supported team SLA performance\. At Optum, I worked on US medical claims, performing audits, second\-level quality checks \(SSF\), and ensuring HIPAA compliance\. ✅ Skilled in working under pressure and meeting tight deadlines ✅ Quick learner and collaborative team player ✅ Strong grasp of healthcare operations, insurance policies, and coding practices I am currently open to new opportunities in the healthcare or insurance domain — especially in Claims Processing, Insurance Operations, or Healthcare BPO \(Remote/Delhi NCR preferred\)\. Let’s connect\!

## Location

Gurugram

## Work experience

Product Specialist at Genpact India Private Limited Delhi, Nov 2022 \- Dec 2024 · 2 yrs 2 mos, Gurugram, Haryana, India, Genpact India Pvt\. Ltd\. – Gurugram 💼 Business Process Associate 📅 November 8, 2022 – December 19, 2024 🔹 Key Responsibilities: Processed and verified life insurance documents and claims as per client specifications Created policy accounts using internal tools and ensured complete and accurate documentation Conducted in\-depth policy research using Power BI and other databases Segregated and indexed claim documents using Citrix Workspace, Facets, and Omega tools Maintained proper claim files, ensuring high accuracy and zero data loss Coordinated with the internal quality and audit team to resolve claim discrepancies Handled high\-priority tasks under pressure while meeting daily SLA and quality benchmarks Ensured compliance with confidentiality standards and client data protection policies Actively supported team goals through collaboration and timely issue resolution Tools & Platforms Used: Citrix Workspace Facets Omega Power BI MS Office Suite

Claims Specialist at Genpact India Pvt\. Ltd\., Nov 2022 \- Dec 2024 · 2 yrs 2 mos, Executed comprehensive life insurance claims processing through detailed document verification, policy analysis, and eligibility determination to ensure accurate claim adjudication and regulatory compliance\. Conducted systematic research and analytical assessments to support informed claim processing decisions, maintaining adherence to organizational standards and industry best practices\. Managed complete claims documentation lifecycle including indexing, categorization, and audit preparation to ensure regulatory compliance and seamless audit readiness\. Facilitated cross\-departmental collaboration with underwriting, legal, and compliance teams to resolve complex claim scenarios while maintaining established processing timelines\. Maintained detailed documentation standards for all processed claims and related activities, ensuring comprehensive audit trails and regulatory compliance\.

Senior Claims Specialist at Optum, Mar 2019 \- Nov 2022 · 3 yrs 9 mos, Gurugram, Haryana, India, Genpact India Pvt\. Ltd\. – Gurugram 💼 Business Process Associate 📅 November 8, 2022 – December 19, 2024 🔹 Key Responsibilities: Processed and verified life insurance documents and claims as per client specifications Created policy accounts using internal tools and ensured complete and accurate documentation Conducted in\-depth policy research using Power BI and other databases Segregated and indexed claim documents using Citrix Workspace, Facets, and Omega tools Maintained proper claim files, ensuring high accuracy and zero data loss Coordinated with the internal quality and audit team to resolve claim discrepancies Handled high\-priority tasks under pressure while meeting daily SLA and quality benchmarks Ensured compliance with confidentiality standards and client data protection policies Actively supported team goals through collaboration and timely issue resolution 🔧 Tools & Platforms Used: Citrix Workspace Facets Omega Power BI MS Office Suite

Claims Associate at UnitedHealth Group \(Optum Global Solutions India\), Mar 2019 \- Nov 2022 · 3 yrs 9 mos, Processed comprehensive Medicare and Medicaid claims with meticulous attention to accuracy while maintaining strict adherence to service level agreements across all healthcare service lines\. Executed detailed member verification protocols utilizing advanced IDRS and EDSS Image systems to ensure data integrity, prevent fraudulent activities, and maintain system security standards\. Performed thorough analytical reviews of prior authorizations, duplicate claims, and explanation of benefits to ensure proper claim handling and optimize reimbursement processes\. Conducted critical Second Set of Eyes compliance assessments maintaining rigorous regulatory compliance standards and ensuring adherence to federal healthcare regulations\. Executed comprehensive medical coding audits including ICD\-10, CPT, and revenue code validation for both inpatient and outpatient classifications to ensure coding accuracy\. Resolved complex member disputes and grievance cases through effective communication, analytical problem\-solving, and comprehensive case management approaches\. Collaborated strategically with internal teams to address claim processing challenges, implement process improvements, and enhance operational efficiency\.

## Education

Bachelor of Arts, Delhi University

High School Diploma, Centre for Police Technology

[View the original profile](https://tal.club/meet/gulshin-chauhan)

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