Dr Alice Chettiar
Mira Road
Summary
Dynamic Health Insurance Professional – Proven expertise at ManipalCigna Health Insurance in claims audits, system automation, and business analysis. Skilled in stakeholder management, project leadership, and hospital negotiations, delivering operational efficiency, compliance, and significant cost savings. Strong track record in team leadership and driving impactful results in claims processing.
Overview
12
12
years of professional experience
12
12
years of post-secondary education
1
1
Certification
Work History
Deputy Manager
ManipalCigna Health Insurance
Mumbai
09.2023 - Current
- Claims Audits – Executed audits to identify discrepancies, ensuring claim accuracy and compliance.
- Project Leadership – Led in-house claims project, managing operations and team training.
- System Development – Directed Healthbuzz system development and UAT using the SDLC framework.
- Process Automation – Implemented automation of claims system to improve efficiency.
- Change Request Management – Oversaw Healthbuzz change requests to ensure smooth system updates.
Assistant Manager (BA) - Claims
Aditya Birla Health Insurance Pvt. Ltd
05.2021 - 09.2023
- Mission Transformation Project – Directed Claims Module development using SDLC, from requirements gathering to deployment.
- BaNCS-IHX & I3 Integration – Led UAT, managed billing reconciliation, and streamlined payment processes.
- Tariff Digitization – Executed UAT, audits, and analysis to digitize claims, enhancing accuracy and efficiency.
- Change Request Management – Oversaw CRs to optimize system efficiency and reduce turnaround time.
- BaNCS Production Support – Analyzed and resolved IT issues in production claims, ensuring business continuity.
- Employee Training – Delivered onboarding and training sessions, driving higher system adoption.
- ICD & PCS Coding – Completed coding for 750+ diseases/procedures, strengthening compliance and claims accuracy.
Medical Officer - Claims
Medi Assist Insurance TPA Pvt. Ltd.
07.2018 - 05.2019
- Claims Savings – Delivered monthly savings of ₹7–13 lakhs in Case Management/LCM.
- Hospital Negotiations – Managed cashless claim disputes by negotiating suspected overbilling and tariff deviations.
- Reimbursement Advisory – Reviewed 4–5 reimbursement claims daily, advising on reasonable and customary charges.
Medical Analyst
Medusind Solutions India Pvt. Ltd
02.2018 - 07.2018
- Health Content Analysis – Conducted analysis at Emergency Care Research Institute to support emergency care research.
- Medical Data Evaluation – Analyzed 100–200 U.S. healthcare products daily for accuracy and compliance.
Assistant Homeopathic Physician
Satva Complete Homeopathic Care- Charitable Clinic
01.2014 - 01.2015
- Homeopathy Consultation – Consulted 10–15 patients daily, delivering treatment for acute and chronic conditions through homeopathy.
Education
Specialized Diploma In Health Insurance -
Insurance Institute of India
09.2024 - 12.2024
Master of Hospital Administration (MHA) -
Tata Institute of Social Sciences
Mumbai 06.2019 - 05.2021
PGDEMS -
Lifesupporters Institute of Health Sciences
Mumbai 01.2016 - 01.2017
BHMS -
C.M.P. Homeopathic Medical College
Mumbai 09.2011 - 01.2017
HSC -
Patkar - Varde College
Mumbai 06.2009 - 06.2011
SSC -
St. Thomas Academy
Mumbai 06.2008 - 06.2009
Skills
- Audit
- Business Analysis
- Requirements Gathering
- SDLC Framework
- Agile / Scrum / Jira
- Advanced Excel
- Negotiation
- Team Leadership
Certification
- Licentiate(III)
- Product Management - Great Learning Academy
- Jira Project Management - Great Learning Academy
- Agile Project Management, Badge - Skillsoft
- Scrum Master 2023 + Agile Scrum - Udemy
- Six Sigma and Lean Foundations and Principles, Badge - Skillsoft
- Certificate Course in Advance Excel, ICIT India Computer Institute, Mumbai
- Data Visualization and Communication with Tableau, Duke University-Coursera
- EMT-B, Lifesupporters Institute of Health Sciences, Mumbai
Hobbies and Interests
- Reading – Mystery and fiction novels
- Baking – Passion for baking
Personal Information
- Date of Birth – 07 July 1993
- Marital Status – Single
Languages
English
Proficient
C2
Hindi
Proficient
C2
Kannada
Elementary
A2
Timeline
Specialized Diploma In Health Insurance -
Insurance Institute of India
09.2024 - 12.2024
Deputy Manager
ManipalCigna Health Insurance
09.2023 - Current
Assistant Manager (BA) - Claims
Aditya Birla Health Insurance Pvt. Ltd
05.2021 - 09.2023
Master of Hospital Administration (MHA) -
Tata Institute of Social Sciences
06.2019 - 05.2021
Medical Officer - Claims
Medi Assist Insurance TPA Pvt. Ltd.
07.2018 - 05.2019
Medical Analyst
Medusind Solutions India Pvt. Ltd
02.2018 - 07.2018
PGDEMS -
Lifesupporters Institute of Health Sciences
01.2016 - 01.2017
Assistant Homeopathic Physician
Satva Complete Homeopathic Care- Charitable Clinic
01.2014 - 01.2015
BHMS -
C.M.P. Homeopathic Medical College
09.2011 - 01.2017
HSC -
Patkar - Varde College
06.2009 - 06.2011
SSC -
St. Thomas Academy
06.2008 - 06.2009