Sushma M
Senior Associate Claims
Bangalore
Summary
Seeking a career opportunity in a dynamic work environment to leverage skills and knowledge for mutual growth. Passionate about contributing to an innovative, collaborative team atmosphere. Committed to continuous learning and professional development for enhanced contributions and success. Eager to make a positive impact and drive results in a challenging, rewarding role.
Overview
7
7
years of professional experience
4
4
Languages
Work History
Senior Associate Claims
Carelon Global Solutions
04.2025 - Current
Key Responsibilities
- Error sessions
- Sharing the process updates to team and explain with examples
- Handling escalation emails
- Trained and supported new team members, maintaining culture of collaboration.
- Consistently maintained strong relationships with clients, ensuring clear communication and timely updates on project progress.
- Handling team and working closely with them. Prepay Audit (Internal Audit)
- Auditing on teams production and updating it in share point.
- Reaching target on a regular basis.
- Processing the High dollar claims with 100% efficiency as its impacts our SLA
Claims Associate
Legato Health Technologies
08.2018 - 04.2025
Key Responsibilities
- Claims Processing and validating payment using legacy systems like mainframe Anthem Service applications.
- Develop and implement audit plans and programs.
- Identify and document internal control weaknesses.
- Develop and document audit findings.
- Conducting error sessions for internal audits to avoid errors.
- Sector: Health Care
Education
B.COM -
Govt First Grade College Peenya
Ben 01.2015 - 2018.01
PUC - undefined
PVP women's College
SSLC - undefined
Vedanth National Public School
Skills
- Good Knowledge of US HealthCare
- Intermediate knowledge on MS office tools
- Ability to interact with business units, clients, compliance, senior management effectively and build good working relations
- Strong time management, prioritization, work organization and multi-tasking Skills
- Ability to work independently and meet the business deadlines with accuracy, demonstrate accountability and ownership
- Quicklearning, Eye on detail,proactively plan and execute tasks with minimal supervision
- Good Knowledge of US HealthCare
Accomplishments
- Received the all-rounder Award for handling team
- Received Workaholic award and 6 perfect experiences awards
- Received Top Gun awards for achieving highest production with 100% quality
- Received appreciations from the clients as well as management for submitting ideas to enhancing the process and reduce errors
- Recognition for providing 100% quality over productivity
- Trained and provided buddy support for more than 12 freshers
Disclaimer
I hereby declare that the information given above is true and correct to the best of my knowledge.
Place:- Bangalore
Regards:-Sushma M
Timeline
Senior Associate Claims
Carelon Global Solutions
04.2025 - Current
Claims Associate
Legato Health Technologies
08.2018 - 04.2025
B.COM -
Govt First Grade College Peenya
01.2015 - 2018.01
PUC - undefined
PVP women's College
SSLC - undefined
Vedanth National Public School