C N Kumaarr
Claims Investigator
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About
Knowledgeable with regard to Medical Insurance Claims, Health Insurance Claims, General Insurance Claims Verification & Investigation.
Experience in Field Investigation with TPA or Insurance Company (Health Insurance). Efficient in Microsoft Office including Word, Excel, and Power point.
Good Communication
Skills – Written as well as Verbal
Experience
Claims Investigator - HI TPA Pvt Ltd - Hyderabad
(2020-12 - 2024-07)
- Visiting to hospitals and Insured locations as the representative of company and collects all required documents.
- Collects all Medical proof documents, such as ICP, Medicine Bills, Hospital bills, Patient statement etc.
- Investigate and survey the location of the Insured to verify the facts of the claims submitted for the company.
- Focus on the finding the authenticity of the claim submitted by the Insured.
- Investigations on the submitted claims by the insured on behalf of the organization to reach a favorable agreement for both.
- Analyze data on utilization, outcomes and costs to determine trends and identify problem areas.
- Scan and upload documents following set procedures.
- Timely submission of collected documents to the company along with necessary proofs.
Claims Investigator - OMS Pvt Ltd - Hyderabad
(2019-04 - 2020-11)
Sr. Claims Process Associate - ACS - Hyderabad
(2017-11 - 2019-01)
Claims Process Associate - OMH - Chennai
(2014-08 - 2017-10)
Admin Executive - MGH - Khammam
(2007-02 - 2013-12)
Education
B.P.T - Bachelor of Physiotherapy - NTR University (2007)
B.Sc. - Bachelor of Science (Biology) - JNRN University (2003)
Intermediate - Board of Intermediate Education, A.P. (2000)
SSC - 10th Standard - Board of Secondary Education, A.P. (1998)
