Team Lead, Claims Examination And Adjustment
Pune, Maharashtra, India
• Orchestrated the establishment of three internal workstreams for medical, dental, and behavioral health claims; increased efficiency of several claims processed by 1.5X from 300K to 500K annually.• Developed and delivered training sessions for new staff and implemented a streamlined documentation process, resulting in a 30% improvement in claim handling accuracy.• Negotiated settlements of $6M annually, demonstrating strong negotiation skills while maximizing claimant satisfaction.• Investigated fraudulent claims, preventing fraudulent payouts totaling $1.5M over 2 years.