Gokul NM

• Improved team productivity by providing ongoing training and support to junior claims representatives.
• Reduced backlog of pending claims by introducing an effective triage system based on priority levels.
• Collaborated with legal and medical professionals to gather necessary information for claim assessments.
• Analyzed complex claims data, identifying trends, and recommending improvements to reduce future risks.
• This process includes calculations such as statistics and fractions to determine member medication and treatment reimbursements in accordance with policy rates.

Handling Anthem USA healthcare documents involves a workflow that verifies patients' medical records and reimburses their treatment amounts according to policy contracts. This process utilizes applications such as WGS (WellPoint Global Solutions), WCF (WellPoint Content Framework), CIW (Anthem Application), and Blue Square. Additionally, these applications are used to retrieve the provider's information, other carriers, and the complete history of the patient.

Responsible for monitoring and reimbursing transactions to employees on behalf of the company (LinkedIn Client)