DEEP CHANDRA MELKANI
Gurgaon,Haryana
Summary
Dynamic Senior Fraud Analyst at Accertify, adept at fraud detection and risk assessment. Successfully streamlined investigation processes, significantly reducing case resolution times. Proven communicator with strong data analysis skills, enhancing fraud identification and minimizing false positives. Passionate about implementing proactive strategies and training teams to foster a culture of fraud awareness.
Overview
6
6
years of professional experience
Work History
Senior Fraud Analyst
Accertify (former Amex)
Gurugram, Haryana
02.2024 - Current
- Streamlined investigation processes, reducing case resolution times significantly.
- Designed robust controls to enhance genuine fraud identification and minimize false positives.
- Conducted thorough investigations into suspected fraud, analyzing financial data and transaction records.
- Developed and implemented proactive fraud detection strategies to identify potential fraud instances.
- Assessed organizational vulnerability to fraud and devised effective risk mitigation strategies.
- Prepared detailed reports on findings from investigations, presenting recommendations to senior management.
- Collaborated with legal, compliance, and law enforcement teams to coordinate fraud investigations.
- Facilitated training sessions for employees on fraud awareness and prevention techniques.
- Assisted in the investigation of fraudulent transactions and related activities.
- Drafted reports summarizing findings from KYC reviews and investigations.
Sr. Authorization Specialist
WNS Globals
Gurgaon
03.2021 - 02.2024
- Worked on multiple softwares like ECW
- Input all patient data including C.P.T against all chemotherapy injectables along with diagnosis code, regarding claims and prior authorizations into system accurately
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel
- Verified eligibility and compliance with authorization requirements for service providers
- Reached out to insurance carriers to obtain prior authorization for testing and procedures
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures
- Authorization on calls and websites with respective insurances
- Analysed medical records and other documents to determine approval of requests for authorization
- Responded to inquiries from healthcare providers regarding prior authorization requests
- Developed and maintained productive working relationships with healthcare providers
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization
- Other Back-end operations for cancer hospital
- Handled a team of 5 new hires, Providing them resolution to their doubt, concern or any query and helping them with the best
- Trained 8 people in the team giving them training, process modules, notes, hands on on dummy account, etc
Sales Associate
FIS Global solutions PVT LTD
Gurgaon
08.2019 - 02.2021
- Adhered to company initiatives and achieved established goals
- Worked with fellow sales team members to achieve group targets
- Helped customers find specific products, answered questions, and offered product advice
- Greeted customers and provided exceptional customer service
- Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices
- Engaged customers in friendly, professional dialogue to determine needs
- Sold various products by explaining unique features and educating customers on proper application or usage
- Answered incoming telephone calls to provide store, products and services information
- Assisted customers with product selection, sizing and styling
- Provided accurate information about products, prices and services
- Developed promotional strategies to increase sales volume
- Assisted teammates with sales-processing tasks to meet daily sales goals
- Handled customer complaints in a professional manner.
Education
MBA - Financial Management
Suresh Gyan Vihar University
JaipurBBA -
Amrapali Groups of Institution
Haldwani12th -
DAV Centenary Public School
Haldwani10th -
DAV Centenary Public School
HaldwaniSkills
- Fraud detection and risk assessment
- Data analysis and investigation
- Report writing and regulatory compliance
- Effective communication skills
- Critical thinking and problem solving
- Microsoft Office proficiency
Disclaimer
I hereby declared that all the facts given here are true to my knowledge. The Resume correctly describes my qualification and me.
Timeline
Senior Fraud Analyst
Accertify (former Amex)
02.2024 - Current
Sr. Authorization Specialist
WNS Globals
03.2021 - 02.2024
Sales Associate
FIS Global solutions PVT LTD
08.2019 - 02.2021
MBA - Financial Management
Suresh Gyan Vihar University
BBA -
Amrapali Groups of Institution
12th -
DAV Centenary Public School
10th -
DAV Centenary Public School
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