Mrunal Shahane
Halifax,Canada
Summary
Detail-oriented professional with over 4 years of experience in healthcare insurance operations, provider enrollment, and claims adjudication. Skilled in reviewing medical and financial documentation, handling sensitive information with discretion, and ensuring compliance with regulatory and program guidelines. Adept at managing large caseloads, coordinating with clients and providers, and delivering accurate, timely outcomes in fast-paced environments. Strong communicator and problem-solver with a collaborative approach and a commitment to high-quality service. Proficient in Microsoft Office and CRM tools including ServiceNow and Salesforce.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Healthcare and Insurance Provider Enrolment Specialist
NTT Data
04.2024 - 06.2025
- Managed provider enrollment processes, reviewing and approving documentation to ensure compliance with program and regulatory standards.
- Maintained accurate records and data integrity for provider information, essential for underwriting and operational reporting.
- Acted as a key point of contact for providers and internal teams, resolving inquiries promptly and delivering excellent service.
- Oversaw high-volume workloads, prioritizing tasks to meet service level agreements and ensure timely processing of enrollment activities.
- Contributed to developing and updating process documentation, enhancing team efficiency and compliance practices.
Healthcare and Insurance Operations Associate- Claims and Enrolment
NTT Data
04.2021 - 04.2024
- Supported claims processing operations, reviewing and verifying claim details to ensure accurate adjudication and compliance.
- Managed member and provider records, maintaining confidentiality and high data accuracy standards.
- Collaborated with clients, providers, and internal teams to resolve discrepancies, clarify documentation requirements, and support seamless operational workflows.
- Prepared reports and documentation to support audits, program evaluations, and quality assurance processes.
- Identified opportunities for process improvement, contributing to increased operational efficiency and compliance.
Technical Support Specialist
Blue Ocean Contact Centers
11.2020 - 03.2021
- Delivered Tier 1 technical support for hardware and software via phone/email
- Resolved customer issues using Salesforce and coordinated with internal tech teams
- Provided troubleshooting assistance for PC/Mac setup and application issues
- Developed excellent phone etiquette and strong written communication for client support
Sales Executive
Sujata Computers Pvt. Ltd
08.2013 - 05.2017
- Responded to customer inquiries and offered product recommendations.
- Generated sales through a consultative approach and client engagement.
- Prepared proposals, quotations, and contractual documents for client projects.
- Managed complete sales processes from requirement analysis to contract finalization.
ERP Technical Support
SumanaBh Software Pvt. Ltd
03.2012 - 10.2012
- Supported ERP modules across banking, education, and pharmacy sectors.
- Worked with development teams to resolve issues via internal ticketing system.
- Participated in module testing and deployment, ensuring seamless client experiences.
Education
Bachelor of Engineering - Electronics
Shivaji University
India07.2010
Skills
- Disability & Health Claims Adjudication
- Provider Enrollment & Documentation Review
- MS Office Suite (Excel, Word, Outlook)
- CRM Tools (ServiceNow, Salesforce)
- Data Integrity & Confidential Information Handling
- Return-to-Work Coordination Support
- Workflow Management & SLA Adherence
- Client & Provider Communication
- Risk Management & Regulatory Compliance
- Report Preparation & Quality Assurance
- Team Collaboration & Interpersonal Skills
- Problem Solving & Decision Making
- Team Leadership & Staff Training
Certification
C11 – Principles and Practice of Insurance (In Progress)
Accomplishments
- Recognized with Best Employee Awards for high performance and project contributions
- Commended by clients for providing innovative and timely solutions
Timeline
Healthcare and Insurance Provider Enrolment Specialist
NTT Data
04.2024 - 06.2025
Healthcare and Insurance Operations Associate- Claims and Enrolment
NTT Data
04.2021 - 04.2024
Technical Support Specialist
Blue Ocean Contact Centers
11.2020 - 03.2021
Sales Executive
Sujata Computers Pvt. Ltd
08.2013 - 05.2017
ERP Technical Support
SumanaBh Software Pvt. Ltd
03.2012 - 10.2012
Bachelor of Engineering - Electronics
Shivaji University
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