Suparna Baug
Assistant Manager – TPA Operations & Claims Processing
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About
Results-driven Assistant Manager with 8+ years of end-to-end TPA operations and health insurance claims expertise across hospital and InsurTech environments. Currently leading a team of 80+ professionals, overseeing 45,000+ claims per month across insurer platforms including Bajaj Allianz, Tata AIG, Aditya Birla Health, IndusInd, and Liberty General. Proven track record of achieving 100% SLA adherence, reducing claims processing time, and improving audit accuracy to 95% within 6 months.
Adept at leveraging data analytics (Power BI, MIS reporting) and AI-enabled tools to drive operational excellence. Experienced in managing government and corporate TPA stakeholders (ESIC, CGHS, Central Railway) and coordinating with Technology and ML teams to enhance portal functionality. Certified in Artificial Intelligence & Generative AI in Insurance, with hands-on experience across Medi Assist, Star Health, CareWorks, HRMS, and UI platforms.
Experience
Assistant Manager - i3systems Pvt. Ltd.
(2022-09)
- Led cross-functional coordination with Technology and ML teams to troubleshoot and enhance portal functionality across insurer UIs including Bajaj Allianz, Tata AIG, Aditya Birla Health Insurance, IndusInd, and Liberty General, as well as Medi Assist and CareWorks platforms, ensuring minimal disruption during technical issues.
- Ensured 100% TAT adherence aligned with agreed SLAs; proactively flagged and resolved deviations before impacting service delivery.
- Conducted Monthly Business Reviews (MBRs) with clients, tracking performance against contractual timelines and SLA commitments.
- Managed a team of 80+ claims professionals, overseeing daily productivity and quality metrics while processing a monthly volume of 45,000+ claims across multiple insurer portals.
- Managed daily MIS reporting and delivered actionable insights to senior leadership for operational decision-making.
- Conducted comprehensive audits of health insurance claims, ensuring compliance with IRDA regulations and medical guidelines — improved accuracy by 95% within 6 months.
Project Lead - i3systems Pvt. Ltd.
(2021-01 - 2022-09)
- Developed an interactive AHT (Average Handling Time) tracking tool using Google Sheets and Apps Script, boosting team productivity and enabling real-time performance monitoring.
- Presented weekly analytical dashboards via Power BI, delivering data-driven insights to operations and leadership teams.
- Streamlined claims workflows by identifying operational bottlenecks, reducing processing time by 20%+ within 3 months.
- Mentored team members across TPA operations and fostered a knowledge-sharing culture that contributed to 100% performance benchmarks.
- Managed daily MIS activities to track output quality, TAT, and team efficiency.
TPA Assistant - Asian Institute of Medical Sciences (AIMS)
(2020-11 - 2022-09)
- Managed end-to-end TPA operations including pre-authorization, billing, claims settlement, and insurer follow-ups on Star Health and Medi Assist portals.
- Coordinated with government and corporate stakeholders including ESIC, CGHS, and Central Railway.
- Maintained consistent insurer follow-ups to ensure timely claim settlement and discharge clearances.
TPA Coordinator - Apex Multispecialty Hospital
(2020-05 - 2020-11)
- Managed patient admission, discharge coordination, and complete TPA documentation.
- Processed pre-authorization and reimbursement claims across multiple insurance panels.
TPA Coordinator - Venus Multispecialty Hospital
(2017-10 - 2020-01)
- Handled front-desk and TPA operations; coordinated with insurers for approvals and patient discharge processes.
- Built strong insurer relationships that reduced approval turnaround time.
Education
MBA - Hospital Administration & Healthcare Management - DY Patil University, Pune
B.Com - Mumbai University
