Accomplished Professional over five year of experience in Insurance underwriting,
Pre-authorization and Customer Services. Proficient in Corporate Operations.
Expert in managing complex environment, coordinating services and responsible for
seamless execution of daily departmental matters.
Looking for next step opportunity to manage its operations to facilitate individual
and organizational growth.
Preparation of reports to share the progress and performance.
To coordinate with recovery team and other stake holders in case of any financial
disputes between banks and customer.
To coordinate with underwriting department for motor insurance and claim
department.
Data analysis of insurance and tracker renewals policies on monthly basis.
To insure strong relationship building between linked departments.
Collaborate with UW, claims and other department to solve complex cases.
Prepare reports on claim approvals and denials.
Consult with Doctors to obtain additional information or clarification.
Approve or deny claims based on medical necessity, policy coverage, and guideline.
To handle customer’s and network hospitals complaints amicably
Make deductions of all irrelevant/non-medical items.
Communicate to clients/branches about queries in claims.
Processing of the Reimbursement claims from initial entry to settlement and
payments to respective clients.
Evaluate, examine, calculate and process medical claims received from network
hospitals and clients.
Maintain MIS daily claim lodged.
Ensure claims are legitimate and settlements are made in line with company
practices and procedures.
Liaise with doctors and other related individuals for clarity on claims lodged.
Make sure that all client as well as hospital queries are adequately answered.
Investigate client’s complaints against medical providers and take necessary
steps to promptly solve matters.
Any special task assigned by manager