Komal Kadam

Senior Executive at Bajaj General Insurance (2021-12 – Present)

Joined as 'Claims Executive' and got promoted as 'Senior Executive' in Nov' 23

Flexible and proficient in both Opus & Maximus software used for claim processing
Handling both retail and group insurance policy cases
Handling escalations and disputes raised by the policy holders or hospitals during claim settlement
Handholding the newly hired processors during their learning curve

Medical Officer at Medi Assist India TPA Pvt Ltd. (2019-08 – 2020-11)

To approve online preauthorization of medical insurance claims based on the treatment suggested, claim history and policy terms and conditions

Strict adherence to the policy T&C and ensure no deviation in claims processing
To inform the Network department in case of any erroneous billing/excess billing observed
Identify and highlight any suspicious case observed to the investigating team
Ensure to process all the claims allocated within TAT

Quality Executive at APOLLO HOSPITAL (2017-07 – 2017-11)

Worked as stroke coordinator on stroke pathway

Management Trainee at ZOI Hospital (2016-12 – 2017-06)

Worked on paperless prescription project for the hospital

Implementation of INSTA software in the hospital
Making templates in INSTA software which would be helpful for paperless prescription project
Understanding the functionality of various departments in the hospital and preparing SOP's for them
Audit on implementation of SOP and ensure it is being followed across all departments
Identify gaps and challenges and bridge them for smooth functioning

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