Anuja Salunke - Padwal

Experienced healthcare TPA professional seeking a Group Leader position where I can leverage my leadership, claims management expertise, and team handling experience to enhance operational efficiency, ensure policy compliance, and drive high-quality customer service delivery. Over 8+ years of experience in Health Insurance TPA operations. Strong experience in handling cashless and reimbursement claims.

Expertise in team supervision, escalations management, and client coordination. Proven ability to maintain TAT, quality control, and regulatory compliance.

Group Leader / Account Manager - MD India Health Insurance TPA Pvt. Ltd.

(2015-09 - 2026-02)

• Supervising and guiding team members handling cashless and reimbursement claims.
• Monitoring TAT, productivity, and quality parameters.
• Handling escalations from hospitals, corporate clients, and insured members.
• Reviewing complex and high-value claims before approval or repudiation.
• Coordinating with insurers and hospitals for claim clarifications and approvals.
• Ensuring compliance with policy terms, insurer guidelines, and regulatory norms.
• Conducting team meetings and performance discussions.
• Preparing daily/weekly MIS and performance reports for management.
• Maintaining quality standards and minimizing processing errors.

Bachelor of Arts - YCMOU, Pune (2022)

Diploma - E&TC - PDEA SRGS Institute of Technology (2014)