Naveen Kumar K

Claims professional with 2.3 years of experience in healthcare claims (overpayment identification, recovery, and adjudication) and 8 months in Property & Casualty claims, currently handling end-to-end claims review. Skilled in coverage verification, claims investigation, discrepancy resolution, and regulatory compliance, with a track record of accurate, high-volume claims processing within strict SLAs.

Claims Analyst – Property & Casualty - Sutherland - Bangalore

(2025-12)

• Review and analyze property & casualty insurance claims to determine coverage eligibility and liability, managing a high-volume caseload with consistently strong accuracy against quality benchmarks.
• Investigate claims by evaluating photos, invoices, statements, and supporting documentation to validate liability before settlement.
• Process claim decisions and settlements in line with policy guidelines, coordinating with adjusters and internal teams to resolve discrepancies.
• Maintain accurate case documentation across multiple concurrent claims, supporting audit readiness and SLA compliance.

Overpayment & Recovery Analyst – Healthcare Claims - Sagility - Bangalore

(2023-08 - 2025-09)

• Reviewed healthcare claims to identify overpayments and payment discrepancies, calculating recovery amounts based on payer billing guidelines.
• Coordinated with internal teams and healthcare providers to initiate recovery actions and process claim adjustments, improving resolution turnaround.
• Maintained detailed documentation for investigations and recovery cases to support compliance and audit trails.
• Ensured adherence to healthcare policies, payer regulations, and recovery procedures across all assigned claim files.

Bachelor of Commerce - Finance & Accounts - Islamiah Men's College (Autonomous) (2020 - 2023)