Summary
Overview
Work History
Education
Skills
Work Availability
Timeline
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Kesiya Varghese

Kesiya Varghese

Claims Felcitation Manager

Summary

Results-oriented Claims Adjuster bringing hands-on law enforcement experience and exceptional leadership and communication skills. Background includes criminal investigation, insurance fraud and surveillance.

Driven, hardworking and veteran Registered Nurse bringing demonstrated patient care, medication monitoring and treatment management expertise. Adaptable and resilient with strong attention to detail, clinical expertise, and emergency response experience. Bringing-year record of success in nursing and desiring Nursing Incharge position with NABH facility.


Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.


Responsible Medical Claims Processor with strong attention to detail and juggles multiple tasks. Bilingual go-getter committed to handling claims expeditiously.

Overview

6
6
years of professional experience
3
3
years of post-secondary education

Work History

Claims Manager

Star Health & Allied Insurance
BANGALORE
10.2017 - Current
  • Determined proper course of action for claims processing.
  • Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times.
  • Interacted with Social Security Administration and other entities for timely processing and delivery of quality customer service and results.
  • Manage up to calls and up to scheduled appointments daily to gather information to initiate claims process.
  • Documented information gathered in field and uploaded data to company database for efficient processing using [Software].
  • Examined claims forms and other records to determine insurance coverage.
  • Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.
  • Documented and communicated timely claims information while supporting accurate outcomes.
  • Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
  • Exceeded clients' expectations by compassionately gathering required medical and work history information to complete applications.
  • Reviewed new files to determine current status of injury claim and to develop plan of action.

Education

Associate of Science - Nursing

SNMVHS
Vannappuram, Iduki District, Kerala
08.2004 - 08.2007

Skills

Claims analysis,

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Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Claims Manager

Star Health & Allied Insurance
10.2017 - Current

Associate of Science - Nursing

SNMVHS
08.2004 - 08.2007
Kesiya VargheseClaims Felcitation Manager