Manisha Jagdale

Experienced insurance operations professional with 8+ years in TPA environments, specializing in claims management, cashless and reimbursement processes, investigation coordination, and CRM support. Strong at strengthening stakeholder relationships, ensuring smooth claim workflows, and delivering accurate MIS reporting in fast-paced, compliance-driven settings.

Claim Adjustor - Raksha Health Insurance TPA

(2016-10 - 2021-07)

• Responsible for cashless & reimbursement claims audit with accuracy & policy compliance.
• Handled corporate and customer queries related to claims with timely resolution
• Prepared daily and weekly MIS reports and generated monthly invoices for performance and billing accuracy.
• Supported portability data processing and trained new associates.

Senior Investigation Executive - Medi-Assist India TPA Pvt. Ltd.

(2016-01 - 2016-07)

• Allocated cashless and reimbursement cases to internal and external investigation agents, ensuring timely case movement.
• Monitored investigation progress and maintained strong follow-up to meet defined turnaround times.
• Responsible for generating monthly invoices and preparing daily + weekly MIS reports for performance review
• Supported grievance handling and follow-ups to improve customer satisfaction and operational efficiency.

Claim Executive – Operations - MD India Healthcare TPA

(2010-01 - 2013-03)

• Managed end-to-end registration of cashless and reimbursement claims within the in-house system, ensuring accuracy and timely processing.
• Handled corporate and branch-level investigation queries, ensuring clear communication and issue resolution.
• Managed CRM case logging, tracking, and escalation to maintain service quality and turnaround times.
• Ensuring timely dispatch of claim settlement cheques to customers, insurers, and hospitals.

Post Graduate Diploma - Risk and Insurance - MIT College, Pune

Master of Arts - Economics - Pune University