Dipali Shelar

- Managed the processing of Dell claims and conducted quality checks (QC).
- Strategically allocated daily claims to optimize efficiency.
- Led training sessions for new hires and addressed their inquiries.
- Worked on complex claims as part of the DTW task force.
- Maintained a quality target of over 95% throughout the year and received recognition for achieving 98% in critical DTW claims.
- Achieved 100% daily productivity and completed all tasks on time.
- Received positive feedback from leadership for the quality of work.
- Prepared Start of Day (SOD) and End of Day (EOD) reports and facilitated error review sessions.
- Developed a VAT calculator for Turkey to enhance efficiency.
- Improved the reversal process and proposed new ideas for enhancing procedures.
- Conducted claims audits and quality checks for Red Hat and Cisco.
- Managed payment processing and work allocation for Cisco

- Led a team of 25 individuals, ensuring smooth operations and maintaining high performance.
- Managed team activities, including leave, appraisals, and promotions.
- Oversaw hiring and contributed to tool development.
- Processed both outpatient and inpatient claims, including complex cases.
- Resolved web grievance tool issues while ensuring compliance.
- Allocated work and monitored turnaround times and quality metrics.
- Prepared performance reports with key metrics.
- Conducted investigations and fraud checks to mitigate risks.
- Ensured timely claim payments and managed audits with insurance companies.
- Handled client and insurance escalations for quick resolutions.
- Performed quality checks and trained junior members.
- Successfully delivered client projects and implemented new processes.
- Coordinated corporate policy renewals and updated guidelines.
- Built strong relationships for hospital empanelment and networking.
- Collaborated with the MBBA team for medical opinions on critical cases.