KOLA GEETHA DEVI
Hyderabad
Summary
Secure a responsible position in a reputed organization to fully utilize my training and skills, while making a significant contribution to the organization. Capable claims representative adept at claims investigations, information review and settlement management. Positive and reliable professional with a detail-oriented and systematic approach. Bringing several years of related experience.
Overview
4
4
years of professional experience
Work History
Senior Claims Associate
Carelon Global Healthcare solutions
08.2021 - Current
- Collaborative mind-set and willingness to work with people outside immediate reporting hierarchy to improve processes and generate optimal departmental efficiency
- Determine and resolve workload and assignment issues to ensure effective claims processing, expense management and claims disposition
- Dealing with clients who want to settle disputes (Provider & Member) and appeal the rejects insurance claims
- Third party administrator oversight and management, including auditing of same
- Attend client meetings and industry functions to support retention and development of client relationships and business
- Manages both new claims and open claims equally and maintains decision times
- Works directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis
- Exhibits claim management performance according to quality and compliance standards
- Determines customer eligibility by reviewing contractual language and medical documentation, interprets information and makes decisions based on facts presented
- Development and execution of claim strategies as well as resolution strategies.
Data Curation Associate
Jukshio Technology Innovation Pvt. Ltd.
10.2020 - 08.2021
- To ensure that data is collected, organized, and maintained in a manner that supports accurate and responsible use in various applications, including Artificial Intelligence (A.I.)
- Data discovery, sourcing, organization and cataloging
- Data quality , validation, preservation and versioning
- Data access and security
- Data sharing and collaboration.
Education
B. Pharmacy -
Vijaya College of Pharmacy, JNTU
01-2020
Skills
- Claims Adjudication
- Claims Processing
- Claims Adjustments
- Auditing
- Windows 7
- MS Office 2010,2013 (Word, Excel, PowerPoint)
Accomplishments
- 1ST Prize for a Poster presentation on Tetra Amelia Syndrome at Vijaya College of Pharmacy.
- Participated in NSS Programs like World Soil Day & Road Safety Awareness Campaign.
Seminarsconferences
- Presented a Poster presentation on Tetra Amelia Syndrome at Vijaya College of Pharmacy.
- Participated in Inter college Elocution Competition on KILL THE CANCER organized by Iskcon Kukatpally.
- Participated in 70TH IPC at Amity University, Noida.
Training
- Industrial training in GOLDFISH Pharma Pvt. Ltd, Kukatpally, HYD
- Industrial visit at RA CHEM Pharma Ltd, Nacharam, Secunderabad, Telangana
Timeline
Senior Claims Associate
Carelon Global Healthcare solutions
08.2021 - Current
Data Curation Associate
Jukshio Technology Innovation Pvt. Ltd.
10.2020 - 08.2021
B. Pharmacy -
Vijaya College of Pharmacy, JNTU
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