Summary
Overview
Work History
Education
Skills
Timeline
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SAJITH SERALATHAN

Toronto,Canada

Summary

Analytical and focused Medical Claims Examiner known for maintaining high productivity and efficiently completing tasks. Skilled in interpreting complex healthcare codes, analyzing medical claims, and ensuring compliance with policies. Excel in communication, problem-solving, and time management to enhance workflow and client satisfaction.

Overview

8
8
years of professional experience

Work History

Senior Medical Claims Examiner

Canada Life
London, Canada
08.2023 - 02.2025
  • Applied knowledge of healthcare regulations, laws, policies, procedures, guidelines and best practices when making decisions related to claims adjudication
  • Maintained accurate documentation on all claim files in accordance with company standards
  • Interpreted terms of insurance policies to determine validity of claim
  • Conducted research to gather information supporting or refuting claim
  • Communicated effectively both verbally and in writing with customers, clients and other departments within the organization
  • Analyzed medical records to ensure coverage eligibility and compliance with policy terms
  • Researched billing errors and denials using various resources including carrier websites and databases
  • Inputted data into the system, maintaining accuracy of provider coding information and reported services.
  • Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.

Financial Services Representative

TD Canada Trust
Markham, Canada
01.2020 - 08.2023
  • Provided customers with the best solutions and offer guidance on how TD's digital assets can further help them meet there needs, now and in the future.
  • Delivered outstanding service with minimal to moderately complex transactions related to financial products and services, with the aim of providing complete and correct solutions the first time.
  • Worked toward achieving set goals while being an ambassador for innovation by offering legendary experiences and trust.
  • Helped customers Complete applications for credit cards, Line of credits and other products.
  • Detected fraud and took appropriate measures to protect customer accounts and privacy.
  • Analysed financial data to identify opportunities for increasing profitability.
  • Received and processed deposits, withdrawals and loan payments, keeping financial records up-to-date.

Retention Specialist

Rogers
Toronto, Canada
12.2016 - 08.2020
  • Provided excellent customer service and ensured customer satisfaction
  • Answered customer telephone calls promptly and in appropriate manner
  • Communicated accurate information about promotions, customer programs and products, providing exceptional customer service and driving retention
  • Educated customers about brand to incite excitement about company's mission and values
  • Documented all customer inquiries and comments thoroughly and quickly

Education

Bachelor of Science - Environmental Science

University of Toronto
12.2024

Skills

  • Policy interpretation
  • HIPAA compliance
  • Microsoft Office Applications
  • Claims processing
  • Keyboarding Skills
  • Leadership
  • Microsoft Office Suite
  • Medical billing
  • C and C proficiency

Timeline

Senior Medical Claims Examiner

Canada Life
08.2023 - 02.2025

Financial Services Representative

TD Canada Trust
01.2020 - 08.2023

Retention Specialist

Rogers
12.2016 - 08.2020

Bachelor of Science - Environmental Science

University of Toronto

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SAJITH SERALATHAN