Likhit Kottaru
U.S Healthcare
Bangalore
Summary
Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach. Analytical problem-solver with excellent communication skills. Effective at interviewing claimants, compiling records and documenting findings. Well-versed in insurance policies, practices and standards. Background includes claims processing in fast-paced environments. Adept at handling uncomplicated claims from first contact through final settlement. Fluent in English, Telugu, Kannada, Hindi. Experienced in ITS, NON ITS Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities.
Overview
2
2
years of professional experience
8
8
years of post-secondary education
Work History
Claims Associate
Legato Health Technologies
Bangalore
10.2020 - Current
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Affirmed or denied coverage fairly based on thorough investigations.
- Examined reports, accounts and evidence to determine integrity and accuracy of information.
- Evaluated and settled complex insurance claims in strict timeframes.
- Proposed settlements for uncomplicated issues to resolve claims.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Checked level and type of coverage and evaluated contracts.
- Determined appropriateness of payers to protect organization and minimize risk.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Calculated adjustments, premiums and refunds.
- Checked documentation for accuracy and validity on updated systems.
- Modified, updated and processed existing policies.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Reviewed 300-400 patient cases per week and verified insurance coverage information
Education
High School Diploma -
Sri Ramakrishna Gurukul Residential School
Shimoga, Karnataka 07.2012 - 06.2013
P U - Commerce
S G College
Koppal, Karnataka 07.2013 - 06.2015
Bachelor of Computer Applications - Accounting And Computer Science
Indo American Degree College
Bellay, Karnataka 07.2016 - 06.2019
MBA - Finance
Gems Business School
Bangalore, Karnataka 08.2019 - 11.2021
Skills
Policy understanding, Documentation review, Settlement determinations
Claims, Insurance coverage verification, Understanding of medical terms
Coverage assessments, Data integrity, Insurance industry experience
Excellent administrative abilities, Great mathematical skills, Account management
Reporting skills, Teambuilding, Prior authorization processing
Audit claims
ITS & NON ITS CLAIMS
Sweeps claims
84 Adjustment claims
Claims adjudication
System issue claims
Solution Central
IQT's
Timeline
Claims Associate
Legato Health Technologies
10.2020 - Current
MBA - Finance
Gems Business School
08.2019 - 11.2021
Bachelor of Computer Applications - Accounting And Computer Science
Indo American Degree College
07.2016 - 06.2019
P U - Commerce
S G College
07.2013 - 06.2015
High School Diploma -
Sri Ramakrishna Gurukul Residential School
07.2012 - 06.2013