Abhishek Sharma
Property & Casualty Insurance
Ghaziabad
Summary
With over fourteen years of experience in the US property and casualty insurance industry, expertise has been gained in claims management and underwriting. A successful track record in collaborating with adjusters for prompt handling of intricate claims and working closely with underwriters to streamline new business and renewal processes has led to significant growth and customer retention.
The skill set encompasses risk assessment, policy formulation, regulatory compliance, and leveraging advanced insurance technology for enhanced productivity. Strong communication skills and a collaborative approach contribute to achieving business goals while maintaining exceptional customer service. Flexibility and adaptability in the face of a constantly evolving insurance industry make for an ideal candidate in this domain.
Overview
15
15
years of professional experience
6
6
years of post-secondary education
Work History
Team Leader
Cognizant Technology Solutions India Pvt Ltd
Noida
03.2016 - Current
- Obtained underwriting approval by completing application for coverage.
- Ensuring timely issuance of policies by team per underwriting instructions.
- Identified potential risks in client businesses and recommended appropriate insurance coverage.
- Prepared and reviewed insurance applications to verify compliance with regulations.
- Monitored changes in insurance industry to stay compliant with relevant laws and regulations.
- Acted as subject matter expert, answering internal and external questions and inquiries.
- Researched and resolved routine and complex issues.
- Maintained confidentiality of patient finances & records.
- Reviewed credit reports, financial statements and transactions to verify accuracy and completeness.
- Evaluated applications to determine insurance coverage and appropriate risk classifications.
- Developed and implemented underwriting policies and procedures, establishing useful and accurate processing of applications.
- Analyzed data to identify trends and predict future insurance needs.
- Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.
- Conducted regular reviews of operations and identified areas for improvement.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Collaborated with other professionals to develop innovative underwriting solutions.
- Self-motivated, with strong sense of personal responsibility.
- Recorded & processed new/renewal policies.
- Notified insurance agents and accounting departments of policy cancellations and changes.
- Modified, updated and processed existing policies.
- Calculated adjustments, premiums and refunds.
- Supported review, acceptance or denial of new or renewal business after carefully reviewing all information.
- Skilled at working independently and collaboratively in a team environment.
Insurance Claims Processor
EXL Service.com India Pvt Ltd
Noida
08.2009 - 03.2016
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Evaluated and settled complex insurance claims in strict timeframes.
- Affirmed or denied coverage fairly based on thorough investigations.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Evaluated accuracy and quality of data entered into agency management system.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
- Managed workload and priorities to meet claims processing meet deadlines.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Monitored claims processing trends to identify potential areas of improvement.
- Developed and implemented quality assurance processes to check accuracy of claims processing.
- Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards.
- Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
Accounts Receivable Associate
Porteck India Infoservices Pvt Ltd
Noida
09.2008 - 07.2009
- Reconciled daily AR ledger and verified proper posting.
- Posted customer payments by recording cash, checks, and credit card transactions.
- Completed daily process adjustments to maintain accuracy.
- Verified discrepancies and resolved clients' billing issues
- Review & process high dollar claims, all inpatient and outpatient claims
- To provide high-end payment processing among Insurance, Service providers and patients
- Study and calculation of EOB/EOR while processing payment
- Review payments & analyze the reason for difference between charges and payments
- Access Insurance websites & their systems to check claim status & Patient's status (eligibility or benefits)
- Maintaining data security while working on personal information of Patient
- Recovery of incorrectly paid claims
- Adjustment of re-submitted claims and generated over payments
Education
MBA - Environmental Studies
Sikkim Manipal University
Gangtok 04.2012 - 07.2014
Bachelor of Commerce - Accounting & Finance, Business Studies, Economics
University of Delhi
New Delhi 01.2003 - 08.2006
Skills
Quote information
Underwriting and adjustments
Health insurance
Life insurance
Claims
Property & Casualty Insuarnce
Policy investigations
Microsoft Office Suite
Subrogation expert
Policy Issuance
Timeline
Team Leader
Cognizant Technology Solutions India Pvt Ltd
03.2016 - Current
MBA - Environmental Studies
Sikkim Manipal University
04.2012 - 07.2014
Insurance Claims Processor
EXL Service.com India Pvt Ltd
08.2009 - 03.2016
Accounts Receivable Associate
Porteck India Infoservices Pvt Ltd
09.2008 - 07.2009
Bachelor of Commerce - Accounting & Finance, Business Studies, Economics
University of Delhi
01.2003 - 08.2006