ANSHIKA SINGH

BCBSAZ- US Health Care Process

• Accurately process 200+ medical and pharmacy claims daily while managing multiple tasks and priorities in a high-volume, fast-paced environment.
• Review and validate coding (ICD-10, CPT, HCPCS); resolve discrepancies directly with providers.
• Identify and escalate claim issues, including potential fraud or abuse, to the appropriate investigative teams.
• Collaborate with cross-functional teams to address and resolve complex claim inquiries efficiently.
• Utilize Facets and related systems to ensure high accuracy and meet or exceed daily productivity goals.
• Maintain strict compliance with HIPAA and ensure confidentiality of member data at all times.

HSBC - UK Process

• Processed and reviewed financial and insurance claims in compliance with internal policies and regulatory standards.
• Investigated discrepancies, identified potential fraud, and escalated high-risk cases as needed.
• Coordinated with internal departments and external partners to resolve complex claim issues.
• Maintained accurate records in claims systems while ensuring data integrity and confidentiality.
• Consistently met performance metrics for accuracy, turnaround time, and case resolution.
• HSBC