MEGHA GUPTA
Gurgaon
Summary
Results-driven professional with experience in Claims Processing, Customer Support, and Finance Operations at Canara HSBC Life Insurance Company. Skilled in claims analysis, quality assurance, financial data validation, and operational process improvement. Proficient in SQL and Power BI for data analysis, reporting, and performance monitoring. Experienced in identifying discrepancies, ensuring compliance with company policies and procedures, and coordinating with cross-functional teams to resolve issues. Committed to improving operational efficiency, maintaining data accuracy, enhancing customer satisfaction, and delivering quality-driven business outcomes.
Overview
7
7
years of professional experience
Work History
Assistant Manager- BRCM (BA_IT_CR)
Canara HSBC Life Insurance Company
Gurgaon, Haryana
12.2022 - Current
- Gathered and analysed business requirements for provision creation and correction in financial schedules to ensure accuracy and compliance.
- Prepared functional requirement documents to support provision-related changes and corrections in financial schedules.
- Coordinated with business and technical teams to address and resolve issues related to provision entries and updates in financial schedules, facilitating smoother operations.
- Coordinated SIT and UAT to validate provision calculations, financial data accuracy, and correction scenarios.
- Managed defects in provision processing and financial schedule discrepancies, ensuring timely resolution to maintain data integrity.
- Analysed existing system functionality and identified gaps in provision calculation, creation, and correction processes.
- Documented business rules, validation requirements, and process flows for provision creation and correction.
- Supported implementation of system enhancements related to provision processing and financial schedule maintenance.
Customer Service Manager
Vidal Health Insurance Tpa Ltd
Gurgaon, Haryana
02.2020 - 11.2022
- Resolved customer complaints while prioritising customer satisfaction and loyalty.
- Built relationships with providers and networks, securing favourable client coverage options.
- Verified insurance coverage by telephone and online, ensuring accurate cashless transactions and reimbursement of benefits while estimating patients' financial responsibilities.
- Performed needs analysis, gathering essential information to recommend suitable health insurance products.
Claims Auditor
MedSave Health Insurance TPA Ltd
06.2019 - 02.2020
- Reviewed medical documents, discharge summaries, investigation reports, prescriptions, and hospital bills to determine claim eligibility and ensure compliance with policy guidelines.
- Evaluated claim settlement calculations and validated admissible amounts to ensure alignment with policy coverage and adherence to applicable guidelines.
- Scrutinised hospital bills and reimbursement documents to detect non-payable expenses, duplicate charges, and billing discrepancies, contributing to accurate claims processing.
- Verified hospitalisation expenses, room rent limits, ICU charges, co-payments, deductibles, and policy sub-limits as per policy terms.
- Processing cashless and reimbursement health insurance claims to ensure compliance with policy terms, conditions, and claim processing guidelines.
Education
Master of Business Administration - Finance
APJ Abdul Kalam Technical University
Agra, UP07-2019
Bachelor Of Commerce - Commerce
Dr. BR Ambedkar University
Agra, UP07-2017
Skills
- Data analysis
- Microsoft Excel/ Advanced
- SQL, PL/SQL
- PostgreSQL
- Power Query
- PowerBI
- Power Automate
Professional Links
http://linkedin.com/in/megha-gupta-analyst
Timeline
Assistant Manager- BRCM (BA_IT_CR)
Canara HSBC Life Insurance Company
12.2022 - Current
Customer Service Manager
Vidal Health Insurance Tpa Ltd
02.2020 - 11.2022
Claims Auditor
MedSave Health Insurance TPA Ltd
06.2019 - 02.2020
Master of Business Administration - Finance
APJ Abdul Kalam Technical University
Bachelor Of Commerce - Commerce
Dr. BR Ambedkar University