Summary
Overview
Work History
Education
Skills
Languages
Personal Information
Timeline
Generic
SALMA KOUSER B

SALMA KOUSER B

Bengaluru

Summary

To seek a challenging job in a growth-oriented company offering, personality and professional development where I can learn improve and fully utilize my abilities to take part in building the organization and thus, be an asset to the organization. Capable claims representative adept at claims investigations, information review and settlement management. Positive and reliable professional with a detail-oriented and systematic approach. Bringing several years of related experience. Skilled in interviewing, records searching and documentation. Excellent critical thinking and organizational abilities. Proficient in insurance policy coverage levels, industry practices and compliance requirements. Proficient claims associate skilled in handling high volumes of claims. Processes adjustments based on identifiable liability and compensability. Supports work of senior team members by organizing documentation and assisting on complex cases. Skilled in handling complex insurance claims and policy processing with experience in navigating through various insurance software systems. Demonstrates strong analytical skills, adept at interpreting policies and efficiently resolving claims to the satisfaction of all parties involved. Known for maintaining high accuracy levels in document processing and data entry, contributing to streamlined operations and improved customer service outcomes. Continuously seeks ways to optimize workflows and enhance team productivity, leading to more efficient claim resolution processes. Efficient Claims Associate known for productivity and the ability to complete tasks swiftly. Possess specialized skills in claim processing, policy interpretation, and dispute resolution. Excel at communication, problem-solving, and time management, ensuring smooth operation in fast-paced environments. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

4
4
years of professional experience

Work History

Claims Associate (Health Insurance)

Carelon Global Solutions
BENGALURU
10.2020 - 09.2024
  • Claims associates control claims for insurance companies and determining a customer’s insurance coverage and evaluating those who have filed a claim
  • Reviewing all the documents and handling customer’s insurance coverage and interviewing those who have filed a claim
  • Thoroughly review and verify all medical documents
  • Maintain and manage customer and their information accurately
  • The process of researching, analyzing the claims and understand how a claim was processed
  • Ensure that submitted claims as obtains full and fair review
  • A well-versed experience on claim adjudication platforms
  • I.e., CIW, WGS, WCF, M-360, ACMP etc
  • Obtaining and verifying the information, correspond with insurance agent and beneficiaries, & process claims
  • Undertake cross-training sessions from other team members to enhance overall team efficiency
  • Microsoft Outlook
  • Ms office
  • Ms Excel
  • Power Pivot
  • Claim Adjudication
  • Claim adjustment
  • Exceeded performance and productivity targets in the role of claims associate
  • Handle requests form highly sensitive clients promptly, exceeding client expectations

Education

BBA - Financial Analysis

SSMRV COLLEGE of Commerce And Management
BENGALURU
09-2020

PUC -

SSMRV PU COLLEGE
Bengaluru
05-2017

High School Diploma -

ROYAL SCHOOL
JP NAGAR
05-2015

Skills

  • Leadership quality
  • Good at public speaking
  • Time and team management
  • Learning attitude
  • Problem solving
  • Claims investigation
  • Claims
  • Settlement agreements
  • Claims processing
  • Microsoft office
  • Claims trend analysis

Languages

  • Kannada (read, write, speak)
  • English (read, write, speak)
  • Telugu (speak)

Personal Information

  • Father's Name: Syed Babu
  • Husband's Name: Raza Mohammed Mujthaba
  • Date of Birth: 04/06/98
  • Gender: Female
  • Marital Status: Married

Timeline

Claims Associate (Health Insurance)

Carelon Global Solutions
10.2020 - 09.2024

BBA - Financial Analysis

SSMRV COLLEGE of Commerce And Management

PUC -

SSMRV PU COLLEGE

High School Diploma -

ROYAL SCHOOL
SALMA KOUSER B