Dr.Shaeida Shaik Email & Phone Number

Bengaluru, Karnataka, India

- Leading teams for health insurance claims management related to policy endorsements and amendments- Performance management Client & channel partner for service supportEnsuring policy complianceOther industrial collaborationsDepartment - Grievance management• Handling union people, ford employees resolving their queries, cashless Approval, settlement Clarifications,Reimbursement checklist & approval guidance.• Insurance Advisor• Medical AdjudicatorFloat… Show more - Leading teams for health insurance claims management related to policy endorsements and amendments- Performance management Client & channel partner for service supportEnsuring policy complianceOther industrial collaborationsDepartment - Grievance management• Handling union people, ford employees resolving their queries, cashless Approval, settlement Clarifications,Reimbursement checklist & approval guidance.• Insurance Advisor• Medical AdjudicatorFloat Reinsurance submissions (Treaty & Facultative) into the internationalreinsurance markets Co-ordinations, follow-ups with reinsurance,Preparation of Presentation materials for clients(power-point, word, excel etc)Maintaining the records of all submissionssystematically and updating it periodicallyPreparation of reports, analysis, market study etc Show less

Banglore

Implemented and managed CRM tools, enhancing communication and streamlining claim.Designed and implemented advanced training programs, elevating team proficiency in complex claims management and CRM utilization.Mastered the resolution of high-volume, intricate insurance claims, achieving exceptional accuracy and compliance with Medibuddy’s stringent policies.Pioneered robust strategies to handle claim denials, conducting meticulous reviews and persuasive appeals that boosted approval rates by… Show more Implemented and managed CRM tools, enhancing communication and streamlining claim.Designed and implemented advanced training programs, elevating team proficiency in complex claims management and CRM utilization.Mastered the resolution of high-volume, intricate insurance claims, achieving exceptional accuracy and compliance with Medibuddy’s stringent policies.Pioneered robust strategies to handle claim denials, conducting meticulous reviews and persuasive appeals that boosted approval rates by 25%.Delivered unparalleled customer support, maintaining a 95% satisfaction rating through proactive and personalized service.processes.Collaborated with cross-functional teams to address client concerns promptly andefficiently.Conducted training sessions for staff, ensuring a consistent and high-quality customerexperience.Vendor management, Provided exceptional customer service by addressing inquiries and concernsrelated to claims status.Specialized in handling complex claims, including denials and appeals, with a focus on resolution and customer satisfaction. Show less

Bengaluru, Karnataka, India

Reviewing, researching, investigating, negotiatingand adjusting health insurance claims,Applying benefits according to provider contractual benefits.Claim adjudication,approving the claims,Processing and analysing subrogationrelated queries.Auditing the claims.IR analysis CRM relation ships…Interaction with clients and solving queries. Responsible for updating end details to manager. Providing feedback on QC Report to the team members on weekly… Show more Reviewing, researching, investigating, negotiatingand adjusting health insurance claims,Applying benefits according to provider contractual benefits.Claim adjudication,approving the claims,Processing and analysing subrogationrelated queries.Auditing the claims.IR analysis CRM relation ships…Interaction with clients and solving queries. Responsible for updating end details to manager. Providing feedback on QC Report to the team members on weekly basis.Supporting team by giving training to new joiner regarding process.Attending Client meeting on monthly basis todiscuss regarding Production, Target Quality andTeam performance.claim adjudication and• Handles Private insurer's claims E2E operations• Handles International -UK claims (Mayfair Insurance company)• External stakeholder Management• QC audit• Revenue management• Works on SOP, TAT, SLA, STP, and NSTP analysis• Supervised and delegated tasks to employees to meet key productivity targets.• Monitored staff performance, continually seeking ways to improve team delivery for optimized financial success.• Reduced process gaps by effectively training new hires on best practices and protocols. Show less

Kurnool, Andhra Pradesh, India

I have performed crucial roles in medication management, patient consultation, and clinical pharmacy services. Responsibilities include reviewing medication profiles, counseling patients, and collaborating with healthcare teams. They also provide drug information, contribute to formulary management, and participate in quality improvement initiatives. Through education, research, and regulatory compliance, they ensure safe and effective medication use, ultimately optimizing patient care… Show more I have performed crucial roles in medication management, patient consultation, and clinical pharmacy services. Responsibilities include reviewing medication profiles, counseling patients, and collaborating with healthcare teams. They also provide drug information, contribute to formulary management, and participate in quality improvement initiatives. Through education, research, and regulatory compliance, they ensure safe and effective medication use, ultimately optimizing patient care outcomes. Show less

Doctor Of Pharmacy - Pharmd, Clinical, Hospital, And Managed Care Pharmacy

Doctor Of Pharmacy - Pharmd, Pharma.D

Diploma In Medical Coding And Billing, Medical Insurance Coding Specialist/Coder, A