Summary
Work History
Education
Skills
Personal Information
Projects
Achievements Awards
Activities
Timeline
Generic

Chaithranjali S

Bangalore

Summary

Dynamic Program Specialist with proven expertise at Neovance, excelling in claims processing and customer service. Adept in insurance guidelines and data entry, I leverage strong problem-solving and leadership skills to enhance client satisfaction and streamline operations. Committed to delivering high-quality results and ensuring compliance with regulatory standards.

Work History

Program Specialist

Neovance (Allegis Services India Private Limited)
Bangalore
11.2025 - Current
  • Completed day-to-day duties accurately and efficiently.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Assisted with customer requests and answered questions to improve satisfaction.
  • Contact insurance companies via phone to verify patient eligibility, benefits, and authorization requirements for services/medications.
  • Accurately enter and update patient demographics, insurance details, and coverage information in Siebel databases.
  • Ensure adherence to payer guidelines and regulatory policies.
  • Coordinate with providers to ensure appropriate CPT codes support services.
  • Documentation- Precisely document calls, coverage details, and tracking numbers.
  • Obtain necessary pre-authorizations and referrals for planned treatments.
  • Inform patients of their financial responsibility (copays,deductibles, coinsurance and out of pocket network) and explain coverage.

Spec Claims Examiner

Great West Global Business Servics India Private llp
09.2022 - 01.2024
  • Reviewed Dental, Medical records and documents to determine coverage eligibility of claims for insurance benefits.
  • Initiated contact with providers to obtain additional information needed for accurate adjudication of claims.
  • Double-checked and reviewed documentation for denied and accepted insurance claims.
  • Reviewed and resolved open claims and change orders to determine entitlement for additional payment.
  • Investigated discrepancies in claims and resolved issues with provider via telephone or written correspondence.
  • Conducted daily reviews on claim files and verified sending of status letters to policyholders.
  • Reviewed medical treatment records, medical bills.
  • Interacted with clients via telephone, email, or in person to discuss claim status and provide updates.
  • Processed claims for payment or forwarded to appropriate personnel for further investigation.
  • Empower- Canada Life

Claims Associate

Carelon Global Solutions India llp
08.2019 - 08.2022
  • Interacted with clients via telephone, email, or in person to discuss claim status and provide updates.
  • Increases client satisfactory by giving 100% quality work resulting in increased work flow to organization.
  • Reviewed medical records and documents submitted by claimants to ensure accuracy and completeness of information provided.
  • Processed payments for approved claims in a timely manner, adhering to established payment schedules and procedures.
  • Performed quality control checks on completed claim files prior to submission for review by management personnel.
  • Verified details with policyholders and requested additional information.
  • Processed claims for payment or forwarded to appropriate personnel for further investigation.
  • Assisted claimants, providers and clients with problems or questions regarding claims.
  • Handled billing related activities focused on medical specialties.
  • Legato Health Technologies llp - Anthem Inc

Education

Bachelor of Commerce - Accounting and Taxation

Kristu Jayanti College Autonomous
Bangalore
05-2019

Pre-University Course - Commerce

St. Charles Women's PU College
Bangalore
03-2016

High School - Bangalore

St.Charles English High School
Bangalore
04-2014

Skills

  • Ms Excel
  • Ms PowerPoint
  • Ms Word
  • Basic python
  • SAP Application
  • Leadership Skills
  • Time Management Skills
  • Problem Solving
  • Data entry
  • Insurance guidelines
  • Medical records review
  • Customer service

Personal Information

  • Date of Birth: 05/23/98
  • Nationality: Indian
  • Marital Status: Married

Projects

Central Host Project and Solutions, Worked on a timely manner and completed the given schedule within 1 year with high accuracy.

Achievements Awards

  • Impact Award for the Best Performance (3 Consecutive Times)
  • Trained on Solution Central for new joiners.
  • Trained on Mappo Claims IA, HHC, SA for new joiners.
  • Mentoring the New Joiners.

Activities

  • NSS Certificate
  • Basic Python Certificate

Timeline

Program Specialist

Neovance (Allegis Services India Private Limited)
11.2025 - Current

Spec Claims Examiner

Great West Global Business Servics India Private llp
09.2022 - 01.2024

Claims Associate

Carelon Global Solutions India llp
08.2019 - 08.2022

Bachelor of Commerce - Accounting and Taxation

Kristu Jayanti College Autonomous

Pre-University Course - Commerce

St. Charles Women's PU College

High School - Bangalore

St.Charles English High School
Chaithranjali S