Shruthi Michezo

Detail-oriented insurance professional with experience in health insurance TPA operations, specializing in claims processing, verification, and coordination. Skilled in handling high-volume workloads while maintaining accuracy and ensuring compliance with policy and TAT requirements.

Senior Executive at Medi Assist Insurance TPA Pvt. Ltd. (formerly Paramount Health Services & Insurance TPA Pvt. Ltd.) (2022-12 – Present)

Joined Paramount Health Services & Insurance TPA Pvt. in December 2022 as Senior Executive to Pre medical for registration of claims, Promoted internally from pre-medical to post claims / Operations based on strong performance

• Post-Claims / Operations/ Denials
• Processing reimbursement health insurance claims
• Verifying documents, medical records, and policy eligibility
• Leading and supporting the team in daily work flow and task allocation
• Handling IFFCO insurance cases and ensuring proper claim processing
• Managing high-volume claims within defined TAT
• Preparing and maintaining daily operational and status reports
• Claim Auditing
• Coordinate with client HR teams for employee additions, deletions, and policy updates to ensure accurate insurance coverage
• Coordinating with hospitals, clients, and internal teams
• Handle queries from insured members, corporate clients, and insurers through email and telephone, ensuring prompt and effective resolution
• Coordinating with internal teams to resolve pending claims, ensuring timely closure in line with TAT requirements, insurance policy provisions, and TPA operational guidelines. Resolving discrepancies and supporting smooth claim settlements
• Coordinate with insurers for delay condonation approvals and claim reprocessing
• Liaising with insurance companies for special approvals, claim re-openings, buffer utilization, and cashless authorizations
• Coordinating regards to Denial claims to insurance co.& handling insurance claim rejections
• Prepared and submitted rejection filing forms with all required supporting details to insurance companies
• Coordinated with insurance companies to ensure timely submission and follow-up of denied claims
• Worked closely with the investigation team to obtain the necessary information and documentation for claim processing
• Followed up on denied claims to support resolution and maximize claim recovery
• Ensuring timely completion of assigned work with accuracy and compliance

Project Support Executive at RC Glass & Plywood (2022-03 – 2022-12)

• Handled project documentation and coordination activities
• Maintained accurate records and ensured timely execution of tasks
• Managed billing-related activities and supported basic accounting documentation

Accounts Executive at Michezo Sports Pvt. Ltd. (2020-12 – 2022-01)

Internship

• Managed billing, invoicing, and account reconciliation processes
• Maintained accurate financial records and ensured proper documentation
• Supported day-to-day accounting operations with attention to detail
• Assisted in procurement operations and coordination with vendors
• Supported purchase process by maintaining records and documentation
• Followed up on orders to ensure timely delivery of materials/services
• Helped in verifying invoices and purchase-related documents
• Maintained accurate procurement data and status reports

Executive (Part-Time) at Trust Chemists & Druggists Pvt. Ltd. (2019-06 – 2020-11)

• Supported back end operations and data management activities
• Maintained accurate records and ensured proper data entry
• Assisted in day-to-day administrative and operational tasks
• Ensured timely updating and organization of information

Bachelor of Commerce (B.Com - General) in Commerce – Bishop Cotton Women's Christian College, Bengaluru (2022)

Pre-University Course (PUC) – Baldwin Girls PU College (2018)

SSLC – St. Meera's High School (2016)