Sivaiah Chari Sriramadasu
Hyderabad
Summary
As a Claims Associate at Carelon Global Solutions India, I process and verify medicare claims for a leading healthcare provider in the US. I use data analysis tools and techniques to ensure accuracy, compliance, and efficiency in the claims management system. I have successfully handled multiple complex and high-volume claims, resulting in improved customer satisfaction and reduced operational costs.
Capable Claims Representative adept at claims investigations, information review and settlement management. Positive and reliable professional with a detail-oriented and systematic approach. Bringing 2 years of related experience.
Overview
2
2
years of professional experience
Work History
Claims Associate
Carelon global solutions
Hyderabad
05.2022 - Current
- Reviewed medical records and documents submitted by claimants to ensure accuracy and completeness of information provided.
- Processed payments for approved claims in a timely manner, adhering to established payment schedules and procedures.
- Resolved customer complaints related to denied or delayed claims in a professional manner.
- Investigated potential fraudulent activities by reviewing claimant's past history of submissions, verifying identity, and obtaining additional evidence when necessary.
- Maintained accurate records of all claim processing activities in accordance with company policies and procedures.
- Performed quality control checks on completed claim files prior to submission for review by management personnel.
- Verified details with policyholders and requested additional information.
- Examined claims, records and procedures to grant approval of coverage.
- Collaborated with fellow team members to manage large volume of claims.
- Organized information by using spreadsheets, databases or word processing applications.
Education
Bachelor of Pharmacy - B Pharma
Bapatla College of Pharmacy
Bapatla11-2020
Skills
- Claims Investigation
- Policy Interpretation
- Insurance knowledge
- Claims Processing
- Data Analysis
- Documentation research
- Microsoft Excel
- Skilled in SQL
Languages
Telugu
First Language
English
Advanced
C1
Hindi
Beginner
A1
Timeline
Claims Associate
Carelon global solutions
05.2022 - Current
Bachelor of Pharmacy - B Pharma
Bapatla College of Pharmacy
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