Swathi Sreekumar
Scarborough,Canada
Summary
Claims Examiner with deep knowledge of the Insurance claims industry. Solid abilities in developing objectives and strategies to settle liability claims. Excellent skills in compiling, categorizing and auditing information to process claims.
Overview
6
6
years of professional experience
4
4
Languages
Work History
Transcriptionist
LXT AI
09.2022 - Current
- Reviewed and edited transcribed reports and corrected material for spelling, grammar, and clarity
- Reviewed completed reports for proper formatting, grammar, and sentence structure
- Stayed organized and kept detailed records to accurately track progress and client information
Claims Examiner
Legato Health Technologies
01.2017 - 05.2022
- Managed large volume of medical claims on daily basis.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Responded to correspondence from insurance companies.
- Paid or denied medical claims based upon established claims processing criteria.
- Researched and resolved complex medical claims issues to support timely processing.
- Followed up on denied claims to verify timely patient payment and resolution.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Verified patient insurance coverage and benefits for medical claims.
- Processed insurance payments and maintained accurate documentation of payments.
- Monitored and updated claims status in claims processing system.
- Generated reports on medical claims processing activities and results.
- Identified and resolved discrepancies between patient information and claims data.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Education
PG Diploma - Global Business Management
Sault College
Toronto, ON12.2023
Bachelors Degree -
Bangalore University
Bangalore, India12.2016
Skills
- Strong attention to detail
- Multi-tasking ability
- Customer service attitude
- Problem-solving skills
- Data entry skills
- Thorough claims reviews
- Health insurance industry knowledge
- Insurance claims processing
- Medical terms and procedure knowledge
- Policy investigations
- Coverage determination
- Negotiation and mediation skills
- Insurance policy coverage knowledge
- MS Excel, Word, PowerPoint, Outlook
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
You only have to do a few things right in your life so long as you don’t do too many things wrong.
Warren Buffett
Timeline
Transcriptionist
LXT AI
09.2022 - Current
Claims Examiner
Legato Health Technologies
01.2017 - 05.2022
PG Diploma - Global Business Management
Sault College
Bachelors Degree -
Bangalore University
Additional Information
Languages Known:
English
Tamil
Kannada
Malayalam
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