Sahil Sodhi

1. Dental Initials-Insurance Associate (Back-End Operations)

• Processed and reviewed dental insurance claims for accuracy, compliance, and completeness, ensuring alignment with company policies.
• Verified coverage, determined benefits, resolved discrepancies, and entered claim data into internal systems.
• Collaborated with dental providers and policyholders to address inquiries, leveraging strong communication skills and dental terminology expertise (e.g., ADA codes, procedures).
• Key Skills: Attention to detail, problem-solving, customer service, and knowledge of dental insurance workflows.

2. MetCore Claims Specialist (Complex Claims Resolution)

• Transitioned to handling rejected claims requiring manual intervention, utilizing analytical skills to resolve complex issues (e.g., coding errors, coverage disputes, policy exceptions).
• Conducted root cause analysis to identify trends in claim rejections and implemented corrective actions.
• Supported team leadership by managing internal workflows, generating performance reports in Excel, and auditing team accuracy.
• Key Achievements: Improved claims turnaround time by 15%” or “Handled 80+ emails daily
• Reduced processing delays by [5%-10%] through process improvements; trained [5-6] team members on critical workflows.

3. Dental Customer Service Specialist (Front-End Email Support)

• Migrated to a front-end customer service role, managing queries via email from policyholders, providers, and dental firms.
• Resolved issues related to claims status, coverage, and benefits by cross-referencing policy details across multiple internal systems.
• Streamlined response templates and workflows to improve efficiency in handling high-volume inquiries.
• Key Skills: Multitasking, written communication, policy interpretation, and technical proficiency in claims management tools.

Key Accomplishments & Skills

• Technical Proficiency: Advanced Excel skills for reporting, auditing, and data analysis; experience with claims management systems.
• Versatility: Successfully transitioned across back-end, critical resolution, and front-end roles, demonstrating adaptability.
• Leadership: Mentored junior associates, audited team output, and contributed to training programs.

• Providing comprehensive assistance to clients and resolving Procedural, process, information, and technical problems for requests from testing center administrators via Inbound Calls, email, and chat

• Monitored and analyzed customer transactions to detect potential fraudulent activities and suspicious patterns
• Investigated and resolved fraudulent transactions, minimizing financial losses and maintaining a high fraud detection accuracy rate
• Conducted investigations and escalated cases in compliance with AML policies and regulatory requirements
• Prepared detailed reports on investigation findings and provided recommendations for fraud prevention strategies

• How to study and choose stocks to buy and the right time to buy
• The process for selecting stocks to sell, determining when to sell, and the selling methods
• Understanding Sharekhan's website and mobile app
• Opening company accounts and educating clients
• Executing up to 10 intraday stock transactions and settling the trades