Ram Kumar
Sr Claims Acissocates
Bengaluru
Summary
Highly skilled and detail-oriented Claims Associate with 3 years 10 months of experience in the insurance industry. Proven record of managing complex claims processes, ensuring accuracy, and delivering exceptional customer service. Seeking a challenging position to utilize my expertise and contribute to the success of the company, Overall 5.1 year experience.
Overview
5
5
years of professional experience
5
5
years of post-secondary education
5
5
Languages
Work History
Sr Associate
Carelon Global solutions
Bengaluru
05.2022 - 09.2023
- Claim - Mentor and train junior claim associates, providing guidance and support in claims handling procedure - Maintain detailed and organized claim files, ensuring all documentation is accurate, complete, and accessible for audits and legal requirements
- Actively participate in team meetings, contribute insights, and collaborate with cross-functional teams to enhance customer experience and achieve department goals
- Received multiple commendations for consistently meeting or exceeding team performance targets, including high customer satisfaction ratings
- Internal Audit to ensure quality of service and payment made is accurate and as per the policy
- Providing end to end support on escalation claims and payment related queries.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Conducted full claim investigations and reported updates and legal actions.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
Claims Associate
Carelone Global Solutions
Bengaluru
11.2019 - 05.2022
- Worked productively in fast-moving work environment to process large volumes of claims.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information
- Followed up with provider on unresolved issues.
- Meeting Production Numbers and Played a key role in IRP (Inventory Reduction Plan
- Maintaining the Quality at my best, on IRP.
- Always being in a front row, for taking the work and working or make the team to work on it
- Assigning Inventory for the juniors if needed, on regular Basis
- Internal Auditing .
- Cross Training Associates And training New Joiners.
- Participating in cultural Events, like Cheer Up souls, and Town Halls.
- Consolidation Production Tracker,Working on Escalation Files, and processing the claim and making it Finalized.
- Educating the Associates on the error.
- Bringing all my work experience together for solving any type of problem, with in short time.
- providing end to end support on escalation claims and payment related queries.
Customer Service Representative
Capita
Bengaluru
08.2018 - 11.2019
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Responded to customer requests for products, services, and company information.
- Provided primary customer support to internal and external customers.Worked for "Water Plus" utility process (Uk ) invoicing.
- Analyzing and providing end to end customer support via mail, invoice generating , rework and payment related queries etc
Education
BCOM - Accounting And Business Management
RBANM's FGC College
Bangalore 06.2015 - 05.2018
Intermidate - Commerce
RBANM'S Pre University
Bangalore 06.2013 - 05.2015
SSLC - Basic
Sri Ramakrishna Education Society
Bangalore Skills
Training and Development
Problem-Solving
Information Collection
Insurance claims processing
Health insurance industry knowledge
Insurance coverage verification
Thorough claims reviews
Multitasking Abilities
Complaint resolution
Staff education and training
Quality control tests
Knowledge of quality systems
Teamwork and Collaboration
Customer service orientation
Preparing reports
Performance improvement
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Sr Associate
Carelon Global solutions
05.2022 - 09.2023
Claims Associate
Carelone Global Solutions
11.2019 - 05.2022
Customer Service Representative
Capita
08.2018 - 11.2019
BCOM - Accounting And Business Management
RBANM's FGC College
06.2015 - 05.2018
Intermidate - Commerce
RBANM'S Pre University
06.2013 - 05.2015
SSLC - Basic
Sri Ramakrishna Education Society