Deebika Sivakumar

Healthcare Operations Professional with 3+ years of experience in Health Insurance Claims Processing and Claims Adjudication Auditing. Skilled in identifying adjudication errors, improving claim quality, and supporting operational efficiency, Strong analytical mindset with expertise in healthcare documentation review, eligibility verification, and quality assurance processes.

HC & INSURANCE OPERATIONS ASSOCIATE at NTT Data Information Processing Services Private Limited (Present)

• Conduct quality audits on processed healthcare claims to ensure accurate adjudication and policy compliance.
• Review approvals, denials, and adjustments based on insurance policy guidelines and claim documentation.
• Identify errors related to coverage determination, eligibility validation, and claim calculation.
• Prepare audit reports highlighting error trends and operational improvement areas.
• Helps to improve claim accuracy and maintain high quality audit standards across operations.

– Hindusthan College of arts and science (2017 – 2020)