Senior Associate | Claim adjudication
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Process Associate at WIPRO in US healthcare sector 2 years of experience in operations as a claim analyst Verify the claim data against the documents and adjudicate the claim in different tools. Ensuring to check the validity of the claim, Member Eligibility and if claim is needs to done some manual intervention. Route claim to necessary department.
Adjudicate the claim as per given set of instruction. Complete all production logs. Processing claim on Automation bot.
I got opportunity to work as an Acting Quality Analyst based on my work and dedication. Supporting team to maintaining Quality benchmark. Analyzing and solving complex problem and guide the team. Floating daily error sheet and follow up for rectification for the same.
Floating of weekly error log - performance check. Taking error review session on weekly basis for team and guide them on errors. Handled and Audited Team of 25+ members Assisted team with various aspects of Claim processing instructions.
Managed team with SME when team lead was unavailable. Expertise in COB claims audit.
Respond promptly to customer inquiries via phone, email, and chat. Handle and resolve customer complaints and concerns in a professional and empathetic manner. Gather and document customer information and interactions in the company's customer database. Work with other teams within the company to resolve complex customer issues. Continuously seek ways to
SR. ASSOCIATE WIPRO LTD. | OCT 2020 - JAN 2023
MoveinSync | FEB 2023 - PRESENT
CALCUTTA UNIVERSITY - BACHELOR OF COMMERCE 2017
MG RUNGTA ACADEMY - HIGHER SECONDARY
Completed Matriculation from Khalsa High School in 2012