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
