Janhavi Tandel
Virar, Mumbai
Summary
Detail-oriented health claims professional with 2 years of experience in claims adjudication, dispute resolution, and efficient claims processing. Expertise in managing MIS reporting, addressing complex claim issues, and ensuring timely resolution of claim-related complaints while maintaining strong customer satisfaction.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Executive-Health Claims
Future Generali India Insurance Company
PCMC
01.2024 - Current
- Handled backend processing of GRO, Social Media and Escalation cases by coordinating with internal teams, compiling case details, and ensuring accurate resolution of escalated health claim complaints.
- Responded directly to customer emails from the Health Claims desk, providing timely and accurate information related to claim status, documentation, and process queries.
- Managed the registration and adjudication of priority health claims, verifying submitted documents and ensuring compliance with internal and regulatory standards.
- Maintained and regularly updated the team’s MIS (Management Information System) for tracking case volumes, resolution timelines, and productivity metrics.
- Prepared detailed weekly reports on team performance and claim processing data to support internal reviews and performance analysis.
Associate - Health Claims
Quess Corp Limited - Future Generali India Pvt Ltd
PCMC
05.2023 - 01.2024
- Supported claim registration, adjudication, and resolution of repudiation and settlement disputes by reviewing documentation and aligning decisions with policy guidelines.
- Handled claim status inquiries and provided backend support for accurate processing and timely communication across internal teams.
Education
MBA - Hospital And Healthcare Management
D.Y. Patil Vidyapeeth
Pune06-2023
Bachelor of Science - Chemistry
Late Shri. Vishnu Waman Thakur College
Virar05-2021
Skills
- Health claims processing
- Claims adjudication
- Regulatory compliance
- Document verification
- MIS management
- Customer relationship management
Accomplishments
- Best performance and quality for Quarter (1, 2, 3 & 4), 2024
- Collaboration Catalyst Award - 2024
- Star Performer of the year - 2024
Certification
- Appearing for licenciate exam - Insurance Institute of India.
Languages
Marathi
First Language
English
Proficient (C2)
C2
Hindi
Proficient (C2)
C2
Affiliations
Passionate dancer having performed in college and family events.
Timeline
Executive-Health Claims
Future Generali India Insurance Company
01.2024 - Current
Associate - Health Claims
Quess Corp Limited - Future Generali India Pvt Ltd
05.2023 - 01.2024
MBA - Hospital And Healthcare Management
D.Y. Patil Vidyapeeth
Bachelor of Science - Chemistry
Late Shri. Vishnu Waman Thakur College
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