MEGHA OLIYA

Team: Stop Loss.

• Performed end-to-end Stop Loss case setup, including policy configuration, enrolment validation, and accuracy checks.
• Ensured compliance with internal guidelines and client requirements.
• Managed high-volume requests with strict turnaround times, consistently meeting SLA targets.

Team: PinnacleCare.

• Handled case intake and member onboarding by reviewing clinical, demographic, and insurance details for accuracy.
• Conducted medical records sorting and provider research to obtain complete, accurate member records.
• Supported care coordination processes by setting up cases in internal systems, enabling smooth client and physician engagement.
• Maintained confidentiality while processing sensitive health information, ensuring adherence to HIPAA and organizational standards.
• Trained team members provide guidance on different processes and internal systems.