MOHIT MOHIT
Bolton,ON
Summary
Diligent Claims Examiner with solid background in processing and evaluating insurance claims. Effectively managed numerous cases, ensuring accurate and timely resolution. Demonstrated strong analytical skills and attention to detail in complex claim assessments.
Overview
4
4
years of professional experience
Work History
Travel Claims Examiner
World Travel Protection
01.2024 - Current
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Participated in cross-functional team meetings to address organizational challenges related to claims management and develop solutions collaboratively.
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
- Handling 25-30 claims each day efficiently without compromising accuracy, completeness, and compliance with company policies.
- Enhanced claim processing efficiency by conducting thorough investigations and maintaining accurate documentation.
- Collaborated with healthcare providers to obtain necessary medical records, ensuring timely and accurate claim adjudication.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Mitigate claim expenses as economically as possible
Claims Examiner
Manulife Insurance
09.2022 - 01.2024
- Investigate and analyze claims, identifying fraudulent activities, enhancing claim accuracy
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claim's examination process
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process
- Maintain detailed records of claim assessments, supporting data-driven decision-making
- Streamlined claim review processes, reducing average processing time by 20% for Public Service Health Care Plan Members
- Facilitated cross-departmental communication to gather essential claim information, improving assessment accuracy and efficiency
Customer Service Advisor
Manulife Insurance
02.2021 - 08.2022
- Expedited claim settlements to policyholders by effectively negotiating with legal representatives and third-party administrators
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices
- Leveraged analytical skills to evaluate complex case information accurately determining appropriate benefit amounts
- Provided exceptional customer service during difficult conversations regarding denied or terminated benefits, offering empathy while upholding company policies
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures
- Improved customer satisfaction by providing timely and accurate benefit information to policyholders
Education
Post Graduation Diploma - Supply Chain Management
Lambton College
North York12-2019
Master of Science - Mechanical Engineering
Rajasthan Technical University
Kota07-2016
Skills
- Claims processing
- Verbal communication
- Data verification
- Microsoft Office Suite
- Healthcare procedures
- Investigative skills
- Coverage analysis
- Claims evaluation
- Decision-making
- Payment processing
- Critical thinking
- Time management
- Microsoft office
Languages
English
Hindi
Punjabi
Timeline
Travel Claims Examiner
World Travel Protection
01.2024 - Current
Claims Examiner
Manulife Insurance
09.2022 - 01.2024
Customer Service Advisor
Manulife Insurance
02.2021 - 08.2022
Post Graduation Diploma - Supply Chain Management
Lambton College
Master of Science - Mechanical Engineering
Rajasthan Technical University
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