Yogita Nilesh Koli
Navi Mumbai
Summary
Dynamic claims processing professional with extensive experience, 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.
Overview
6
6
years of professional experience
Work History
Sr. Associate
Wipro Pvt Ltd
Navi Mumbai
01.2024 - Current
- Enrolling new subscribers/members in facets(Application being used to enroll members by various health insurance companies) with the help of their demographic details.
- Verifying demographic details of the members provided by their respective company
- COBRA Processing
- Process Training & Team Support
- Collaborated with teams to identify process improvement opportunities.
- Facilitated training sessions on quality assurance policies and procedures.
Specialist
Hexaware Technologies Pvt. Ltd.
Navi Mumbai
03.2020 - 08.2023
- Worked on various claims, such as Disability, Cancer, Critical illness, Maternity claims (Normal & C Section Deliveries).
- Reviewed claims for accuracy and compliance with company policies.
- Maintained accurate records of all claim activities in accordance with company policies.
- Investigated claim and settlement deals and reviewed coverage determinations.
- Verified documents to ensure accuracy of information provided by customers.
Education
BA Graduate -
Yashwantrao Chavan Maharashtra Open University
Jalgaon04-2014
Higher Secondary Examination -
M.J. College
Jalgaon 03-2009
Secondary School Examination -
Bhagirath English School Jalgaon
Jalgaon 04-2007
Skills
- Claims processing
- Decision Making
- Quality assurance
- Documentation accuracy
- Process improvement
- Training facilitation
- Investigative analysis
- Regulatory compliance
Disclaimer
I hereby declare that the information furnished above is true to the best of my knowledge.
Hobbies and Interests
- Cooking
- Listening Music
Personal Information
- Date of Birth: 05/11/1990
- Gender: Female
- Nationality: Indian
- Marital Status: Married
Languages
English
Beginner (A1)
A1
Marathi
Native
Native
Hindi
Proficient (C2)
C2
Accomplishments
Trail Blazer Award - 2025 - Excellent Performance
Timeline
Sr. Associate
Wipro Pvt Ltd
01.2024 - Current
Specialist
Hexaware Technologies Pvt. Ltd.
03.2020 - 08.2023
BA Graduate -
Yashwantrao Chavan Maharashtra Open University
Higher Secondary Examination -
M.J. College
Secondary School Examination -
Bhagirath English School Jalgaon