Skip to main content
Sanvi Sarang

Sanvi Sarang

CLAIM EXAMINER – HEALTHCARE / TPA OPERATIONS

Talent
Indore, Navi Mumbai, ThaneMember since August 24, 2026
Healthcare Claims ProcessingClaims AdjudicationTPA OperationsBenefit & Eligibility VerificationDenial ManagementClaims DocumentationProvider Reimbursement ReviewHIPAA ComplianceTitle Insurance OperationsSettlement ServicesDocument VerificationVendor Bill ProcessingPayment DisbursementInvoice ManagementData ValidationQuality ControlAudit ChecksProcess ImprovementError ResolutionReport PreparationCustomer Data ManagementTeam TrainingKnowledge TransferMS OfficeAdvanced ExcelQuickBooksTally ERPSQL ServerVisual BasicResWare
·

Hire this person

Send a job offer directly to this candidate

Healthcare Claims ProcessingClaims AdjudicationTPA OperationsBenefit & Eligibility VerificationDenial Management

About

Detail-oriented professional with 15+ years of experience across healthcare claims and TPA operations, title and settlement insurance services, financial operations, back-office administration, and customer service. Experienced in claims adjudication, eligibility and benefit verification, denial management, documentation, vendor billing, payment processing, title and settlement operations, data validation, quality checks, and process reporting. Strong track record of maintaining accuracy, meeting turnaround times, following compliance requirements, resolving discrepancies, and supporting process improvement and team training.

Experience

CLAIM EXAMINER – HEALTHCARE / TPA OPERATIONS - Integrum Outsource Solutions Pvt. Ltd.

(2023-11)

  • Review and adjudicate inpatient, outpatient, and professional medical claims according to policy guidelines.
  • Verify member eligibility, benefits, deductibles, copayments, and coverage details.
  • Process claim payments and denials while following reimbursement policies and quality standards.
  • Enter monthly distribution charges for group vendors using QuickBooks.
  • Use VBA to process vendor distribution charges, generate check payments, and prepare monthly reports.
  • Download and review invoices from VBA showing distribution of charges across group members.
  • Maintain accurate claim documentation and follow HIPAA and internal quality requirements.
  • Coordinate with providers, brokers, and internal stakeholders to clarify and resolve claim-related issues.
  • Support process improvement initiatives while maintaining accuracy and turnaround-time requirements.

SENIOR PROCESS EXECUTIVE – TITLE & SETTLEMENT INSURANCE SERVICES - Verity Global Solutions, Mumbai - Mumbai

(2020-09 - 2022-11)

  • Prepared purchase and resale agreements in ResWare according to client requirements.
  • Managed document uploads and maintained transaction records using Dotloop and ResWare.
  • Verified deed recordings, mortgage details, and transaction documentation.
  • Reviewed 1099 forms, FIRPTA documents, and seller information for compliance.
  • Processed refund requests and settlement disbursement adjustments.
  • Maintained accuracy and compliance throughout settlement transactions.

SENIOR PROCESS EXECUTIVE – TITLE INSURANCE SERVICES - Altisource Offshore Services, Vashi - Vashi

(2014-11 - 2020-09)

  • Prepared foreclosure information reports using title search packages.
  • Retrieved, reviewed, and validated title-related legal documents.
  • Updated foreclosure reports for attorneys and internal stakeholders.
  • Conducted quality checks and resolved documentation discrepancies.
  • Worked with CIS, ResWare, Netro Online, PVB, and ECB platforms.
  • Supported onboarding and training of new employees.
  • Contributed to process improvement initiatives focused on quality and productivity.

SENIOR EXECUTIVE – CUSTOMER SERVICE - Capita India Offshore Services, Vikhroli - Vikhroli

(2007-06 - 2014-04)

  • Processed and verified customer information in operational systems.
  • Performed data validation and quality assurance checks.
  • Investigated system discrepancies and maintained accurate records.
  • Monitored daily process performance and prepared operational reports.
  • Supported new-joiner training and knowledge sharing.
  • Reviewed error reports and assisted with corrective actions.

Education

Bachelor of Commerce - B.Com - Yashwantrao Chavan Maharashtra Open University (2005)

Skills

CLAIM EXAMINERHEALTHCARE / TPA OPERATIONS

Reviews

Related