Karthikeyan Shankar Raj
Summary
To seek a challenging and rewarding career opportunity in a growth-oriented organization which offer diverse job responsibility and the potential for advancement.
Good communication skills and a good team worker. Ability to work proactively with influencing skills.
Overview
6
6
years of professional experience
Work History
Claims Operations - SME
Accenture
06.2022 - Current
- FNOL registration and motor claims administration.
- Review and analyze insurance claims to determine coverage, liability, and damages.
- Conduct thorough investigations by interviewing claimants, witnesses, and other involved parties.
- Inspect property damage, review medical reports, and analyze police reports to assess claims accurately.
- Determine whether claims should be approved, denied, or escalated for further review.
- Negotiate settlements with claimants or their representatives to ensure a fair, and timely resolution.
- Handling escalation and dealing with contentious claims.
- Conducting Training to new joiners and conducting refreshments trainings.
- Audit calls to provide feedback on a daily basis with the team members.
Claims Adjuster
Save By Switching Global Services
03.2021 - 05.2022
- Investigate the circumstances of incidents by gathering statements, reviewing medical reports, and inspecting damages.
- Assess liability by evaluating evidence, determining fault, and interpreting applicable laws or regulations.
- Educate claimants and insureds on the claims process and their rights under the policy.
- Investigate fraud triggers, identify fraudulent claims, and coordinate with the Special Investigation Unit for their insights.
- Provide timely communication and updates to claimants, policyholders, and stakeholders.
- Evaluate medical reports, and assess the injury value.
- Negotiate settlements with claimants, solicitors, or third parties while maintaining a fair, cost-effective approach.
- Ensure all claim files are properly documented, including investigation findings, communication records, and settlement details.
Process Associate - Claims
WNS Global services
05.2019 - 12.2020
- Investigate injury claims by gathering all necessary information, including statements from claimants and involved parties.
- Evaluate fault and liability by analyzing evidence, statements, and applicable legal principles.
- Identify potential fraud or exaggeration in injury claims.
- Assess the extent of injuries, medical expenses, loss of income, and other damages related to the claim.
- Work with medical professionals to understand the long-term impacts of injuries and treatment requirements.
- Review court documents, and coordinate with solicitors to settle the claim with best possible terms on litigated claims.
- Calculate appropriate settlement values based on medical evidence.
- Find appropriate case samples to justify the settlement amount.
Education
B.com - CA
Dr. NGP Arts And Science College
Coimbatore04-2014
High school -
Breeks Memorial Anglo - Indian Hr Sec School
Ooty04-2011
SSLC -
Breeks Memorial Anglo - Indian Hr Sec School
Ooty04-2009
Skills
- Decision-making
- Team Handling and Building
- Training and mentoring
- Effective communication
- Customer relationship management
- Communication & Interpersonal Skills
- Research and development
- Analytical thinking
Achievements and awards
- Recognized for consistency in maintaining 100% quality score.
- Recognized as top performer for consecutive months for claims closures.
- Recognized as a good performer on most quarterly Townhall meetings.
- Awarded with an I pad by the clients.
Hobbies and Interests
- Travel
- Sports
- Exploring Nature
Languages
English, Tamil, Kannada.
Personal Information
- Father's Name: SHANKAR RAJ.B.S
- Date of Birth: 09/26/93
- Gender: Male
- Nationality: Indian
- Marital Status: Married
Disclaimer
I hereby affirm that the above information furnished is true to the best of my knowledge.
Regards
Karthikeyan S
Timeline
Claims Operations - SME
Accenture
06.2022 - Current
Claims Adjuster
Save By Switching Global Services
03.2021 - 05.2022
Process Associate - Claims
WNS Global services
05.2019 - 12.2020
B.com - CA
Dr. NGP Arts And Science College
High school -
Breeks Memorial Anglo - Indian Hr Sec School
SSLC -
Breeks Memorial Anglo - Indian Hr Sec School
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