Summary
Overview
Work History
Education
Skills
Languages
Accomplishments
Affiliations
Timeline
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Vishal Mahale

Nashik

Summary

Detailed claims processor with several years of experience investigating claim information for correctness. Trustworthy teammate with benefit knowledge and rapport-building skills. Noted for thoroughness and ethical customer service.

Overview

4
4
years of professional experience

Work History

Claims Processor

Go digit general insurance private limited
Pune
10.2023 - Current
  • Developed strategies for improving overall efficiency of the Insurance Claims Processing department.
  • Provided customers with updates on their claims status through email communication.
  • Assisted in resolving customer inquiries and complaints regarding insurance claims processing.
  • Processed incoming mail and faxes related to insurance claims.
  • Compiled statistical reports related to the number and types of processed claims per month.
  • Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.

Associate Consultant

WNS (ALLSTATE)
Nashik
04.2020 - 10.2023
  • Applied knowledge of coding systems such as CPT, ICD 10 and HCPCS codes for proper reimbursement.
  • Processed a high volume of incoming claims in accordance with established policies and procedures.
  • Reviewed history records to determine benefit eligibility for services.
  • Maintained confidentiality of policyholder information in compliance with HIPAA regulations.

Education

BBA - Finance

Sandip University
Nashik, MH
06-2019

Skills

  • Claims review
  • Medical terminology knowledge
  • Critical Evaluation
  • Insurance Regulations Understanding
  • Insurance Claim Forms Review
  • Insurance Coverage Verification
  • Claims Processing
  • Time management abilities

Languages

English
First Language
Hindi
Proficient (C2)
C2
Marathi
Proficient (C2)
C2

Accomplishments

  • Awarded for 100 % accuracy for two consecutive quarters.
  • Awarded for employee of the month for several times in WNS

Affiliations

  • Represented sandip university at all india university cricket association national level.
  • represented our school at state level in different athletics games.

Timeline

Claims Processor

Go digit general insurance private limited
10.2023 - Current

Associate Consultant

WNS (ALLSTATE)
04.2020 - 10.2023

BBA - Finance

Sandip University

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Vishal Mahale