Summary
Overview
Work History
Education
Skills
Languages
Accomplishments
Timeline
Generic

Neelima Krishna

Etobicoke,ON

Summary

Professional claims specialist with strong record in handling and resolving complex claims efficiently. Adept at analyzing data, identifying discrepancies, and providing solutions that drive positive outcomes. Effective team collaborator with focus on achieving results and adapting to evolving requirements. Skilled in negotiation, customer service, and regulatory compliance, consistently ensuring accuracy and fairness.

Overview

3
3
years of professional experience

Work History

Claims Specialist

World Financial Group Wfg
09.2023 - Current
  • Interviewed claimants and witnesses to gather factual information.
  • Examined photographs and statements.
  • Consulted police and hospital records when needed.
  • Investigated and processed health and liability insurance claims for policyholders.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Investigated and assessed damage to property and reviewed property damage estimates.

• Finalized settlement files for insurance claim payment release.

Clinical Documentation Specialist

Inventrous Knowledge Solutions
06.2021 - 08.2023
  • Generated chart notes for Us Healthcare with high accuracy rates and appreciable TAT ratios.
  • Played an integral role in the successful implementation of new EHR software, providing valuable input during system design phases and facilitating seamless transition periods for all involved parties.
  • Maintained strong knowledge of medical terminology, diseases and conditions and procedures.
  • Managed electronic clinical documentation and uploaded changes or updates using.
  • Maintain up-to-date knowledge of U.S. healthcare regulations, including Medicare, Medicaid, and private insurance documentation requirements, to avoid discrepancies and audit risks.
  • Enhanced patient care by ensuring accurate and complete medical records through timely and efficient documentation practices.
  • Analyzed data from audits to identify areas for improvement in clinical documentation processes, implementing targeted interventions for positive change.

Education

Healthcare Leadership -

Sault College of Applied Arts And Technology
Toronto, ON
04-2024

HARP -

George Brown College
Toronto, ON
03-2024

Medical Terminology - Healthcare

Sault College of Applied Arts And Technology
Toronto, ON
09-2023

Bachelor of Dentistry -

Sri Hasanamba Dental College And Hospital
Karnataka, India
02-2021

Skills

  • Claims Processing
  • Claims Investigation
  • Verbal Communication
  • Microsoft Office
  • Coverage assessments
  • Settlement determinations
  • Compliance Management
  • Policy Interpretation
  • Documentation Review
  • Claims analysis

Languages

English
Native or Bilingual
Hindi
Native or Bilingual

Accomplishments

  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Resolved product issue through consumer testing.

Timeline

Claims Specialist

World Financial Group Wfg
09.2023 - Current

Clinical Documentation Specialist

Inventrous Knowledge Solutions
06.2021 - 08.2023

Healthcare Leadership -

Sault College of Applied Arts And Technology

HARP -

George Brown College

Medical Terminology - Healthcare

Sault College of Applied Arts And Technology

Bachelor of Dentistry -

Sri Hasanamba Dental College And Hospital
Neelima Krishna