Experienced professional with a strong background in the US mortgage domain, currently serving as an Associate at Accenture India Private Ltd, Mumbai. Demonstrates expertise in pre-foreclosure processes, bankruptcy validation, and loss mitigation strategies, while ensuring compliance with investor guidelines such as FHLMC and FNMA. Previously held roles as Senior Analyst at SitusAMC India Private Ltd and Pre-Purchase Reviewer at Sutherland Global Solutions, focusing on closing document preparation, risk assessment, and loan underwriting. Skilled in team management and leadership, proficient in MS Office applications including PowerPoint and Excel. Career goals include advancing within the mortgage industry to drive innovative solutions for complex financial challenges.
Claim Processing: Reviewing and processing healthcare insurance claims with
established guidelines, policies and procedures.
• Claim Adjudication: Determine the eligibility of claims based on policy
coverage, medical necessity & Contractual Agreement between providers &
Payers.
• Documentation: Maintain accurate and comprehensive claim records including
all relevant patient and insurance information, services provided and payment
details.
• Investigation: Investigate and resolve claim discrepancies, denials and appeals
by communicating with healthcare providers, insurance carriers and patients
as necessary.
• Coding: Ensure that claims are coded correctly and in compliance with
healthcare coding standards (Eg. ICD-10, CPT) to facilitate accurate reimbursement.