Description
HAVING 9 years of experience in Insurance Industry actively involved in healthcare insurance and data conversion, development and implementation of supply chain solutions and data analysis with profound experience in automotive and Auto industries. * A highly motivated analyst with vast experience in interpreting, analyzing and reconciliation of data obtained from a variety of sources skills involve development and enhancement of the existing processes and methods to meet both internal and external analysis requirements. * Adept at developing comprehensive productivity reports and doing research on historical production data. * Strong experience in analytical and quantitative techniques including predictive modeling and multivariate analysis. * Handling overall activities of all Travel (Medical and Non -Medical) claims settlement as per policy terms and conditions at a senior level. * Ensure and manage high level of customer service achieved by the all processes. * Interacting with client / customers and improve relations with them. * Coordinating with International / Domestic customers and Insurance companies for Daily Cashless hospitalization requests on Daily basis. * Analyzing the adjudication process and develop job aids to ensure smooth flow of work process. * Knowledge of CPT codes, ICD-9, ICD-10 and HIPPA claims processing (Medical, Dental and vision) * Actively involved in conducting various refresher trainings to the existing team on various new process developments * Conduct Quality Audits of claims processed by the team as per parameters set by Client. * Documentation of Daily / Weekly (MIS) reports as per requirement of senior management team. * Developed and built a predictive risk evaluation tool for application through the supply chain base. * Developed Criticality matrix for supply chain risk assessment and development priorities for low spend supply base. * Has great commitment to and affinity to meet deadlines without compromising accuracy and quality of work. * Good communication, interpersonal, problem analyzing and solving skills. * Possess a high level of claims ability.
Education
| SCHOOL | MAJOR | YEAR | DEGREE |
|---|---|---|---|
| Deemed University of Mumbai | 2006 | Bachelor Degree | |
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