Inthuja Karunanithy
Barrie
Summary
Results-driven claims examiner with a strong background in evaluating and processing healthcare claims. Skilled in analyzing complex information, ensuring compliance with regulations, and delivering exceptional customer service. Seeking to leverage strong analytical, advocacy, and communication skills to transition into a disability case manager role.
Overview
14
14
years of professional experience
Work History
Senior Medical Claims Examiner
Canada Life Assurance Company
08.2023 - Current
- Adjudicated complex medical and drug claims by evaluating contractual obligations and medical documentation to determine eligibility and appropriateness of benefits
- Effectively communicated with clients through email and letter correspondence, addressing inquiries promptly and enhancing overall client understanding
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process
- Successfully processed an average of 300 claims per week, maintaining a 98% accuracy rate, and achieving departmental productivity goals
- Promoted from Claims Examiner to Senior Claims Examiner after demonstrating exceptional skills in claims processing, client relations, and problem-solving
- Trained and onboarded new claims examiners, implementing structured training programs that improved processing accuracy
Claims Processor
Canada Life Assurance Company
12.2021 - 09.2022
- Verified patient eligibility, checked benefits, and confirmed provider details to ensure accurate and timely claims processing
- Collaborated with healthcare providers, medical professionals, and policyholders to resolve discrepancies in claims and ensure proper documentation was submitted
- Analyzed medical records, treatment plans, and billing codes to ensure appropriate reimbursements and identify fraudulent claims
- Processed and reviewed 80 claims per day, maintaining a 99% accuracy rate, ensuring compliance with industry regulations and internal policies
Intake Coordinator
Health Bound Health Network
12.2016 - 04.2018
- Conducted comprehensive assessments of client needs to determine eligibility for services, ensuring accurate documentation and timely processing
- Efficiently managed a high volume of incoming calls, averaging 60 calls per day, while maintaining composure and delivering exceptional client service in fast-paced environments
- Collaborated with healthcare providers, case managers, and external agencies to facilitate seamless service delivery and resolve client inquiries
- Received and reviewed all patient electronic and hard copy medical records for completeness, accuracy, and compliance within regulations
- Built and maintained key relationships with internal and external customers, while delivering outstanding customer service
Administrative Assistant
Gertex Distributing Inc.
01.2013 - 01.2015
- Proficiently and professionally responded to customer and sales representatives' inquiries pertaining to purchase orders, product availability, backorders, price, products and services, procedures, and policy
- Successfully attended to a high volume of inbound calls on the switchboard and relayed detailed information to customers
- Created and maintained front office filing, including keeping track of sales orders, from the organization through all stages of fulfillment and delivery
- Performed a variety of concurrent tasks, handled escalations, time-critical issues and created reports
Administrative Assistant/ Proposal Writing Assistant (Internship)
Heritage Skills and Development Centre
01.2011 - 01.2012
- Managed projects and maintained daily operations of the newcomer services department in conjunction with the Director
- Responded to inquiries and courteously assisted clients within high-volume, deadline-driven settings
- Drafted and edited all correspondence including proposals, acknowledgment letters, holiday greetings, and other training materials
- Assisted the Social Service coordinator in the implementation of programs offered by the department and governmental agencies
Education
Bachelor of Science - Psychology & Neuroscience
University of Toronto Scarborugh
Scarborough, ON09-2012
Skills
- Microsoft Office
- Medical Terminology
- Problem solving skills
- Multi-Tasking Skills
- Customer Service Skills
Languages
English
Tamil
Hobbies and Interests
- Hiking
- Camping
- Reading
Timeline
Senior Medical Claims Examiner
Canada Life Assurance Company
08.2023 - Current
Claims Processor
Canada Life Assurance Company
12.2021 - 09.2022
Intake Coordinator
Health Bound Health Network
12.2016 - 04.2018
Administrative Assistant
Gertex Distributing Inc.
01.2013 - 01.2015
Administrative Assistant/ Proposal Writing Assistant (Internship)
Heritage Skills and Development Centre
01.2011 - 01.2012
Bachelor of Science - Psychology & Neuroscience
University of Toronto Scarborugh
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