Khushi M

Insurance professional with 20+ years of experience in the Health Insurance and TPA industry, specializing in Grievance Redressal, Claims Support, Customer Service, Operations Management, and Team Leadership. Extensive expertise in handling IRDAI-referred grievances, coordinating with insurance companies and policyholders, managing customer escalations, and ensuring regulatory compliance. Proven ability to lead teams, improve service quality, streamline operational processes, and maintain high levels of customer satisfaction.

Grievance Redressal Lead - Vidal Health Insurance TPA Pvt. Ltd. - Gurgaon

(2022-05)

• Handle and resolve grievances received through website, email, letters, phone calls, and IRDAI references.
• Coordinate with insurance companies to ensure timely resolution of customer complaints.
• Lead and manage the Grievance Redressal Team.
• Monitor grievance resolution timelines and ensure compliance with regulatory requirements.
• Liaise with departments including Claims, Enrollment, Cashless, and Investigation for case resolution.
• Prepare and analyze MIS reports for management and insurance partners.

Customer Support Manager - Vipul MedCorp Insurance TPA Pvt. Ltd. - Gurgaon

(2012-11 - 2022-04)

• Managed grievance cases and customer escalations.
• Coordinated with insurers and internal departments for effective complaint resolution.
• Ensured adherence to service standards and regulatory guidelines.
• Maintained grievance records, reports, and MIS documentation.
• Communicated regularly with policyholders regarding case status and outcomes.

Team Leader – Call Center - Vipul MedCorp Insurance TPA Pvt. Ltd. - Gurgaon

(2009-04 - 2012-10)

• Managed customer service operations and client interactions.
• Resolved customer and operational escalations efficiently.
• Prepared attendance records, duty rosters, and workforce schedules.
• Generated MIS reports and analyzed operational performance.
• Coordinated with internal stakeholders to improve service delivery.

Process Associate – Call Center - Vipul MedCorp Insurance TPA Pvt. Ltd. - Gurgaon

(2006-01 - 2009-03)

• Handled inbound Mediclaim-related customer queries.
• Provided information on claim procedures, benefits, and policy services.
• Assisted customers in resolving claim-related concerns.
• Maintained service quality and customer satisfaction standards.

Executive - M/s Sterling Enterprises - Gurgaon

(2004-06 - 2005-12)

Licentiate - Insurance - Insurance Institute of India

Bachelor of Commerce - Commerce - Delhi University

Senior Secondary Education - S.D. Girls Sr. Sec. School, Hisar, Haryana

High School - S.D. Girls Sr. Sec. School, Hisar, Haryana