Dr.Swati Fund

Experience

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  ICICI Prudential Life Insurance Company Limited

  Dec 2010 - Mar 2013

  Process Leader, Health Claims

  - Spearheading as Senior Processor claim processes; examining medical process of hospital and pharmacy claims in accordance with all plan and policy provisions and efficiently handling all process related queries.- Interacting with the branches to resolve claim disputes - Grievance management - Interacting with Service Recovery Unit team, Legal team, and Payout team to resolve Escalations & Grievances.- Maintaining department requirements for productivity, accuracy of claim payment and ensuring that all claims are processed in a timely manner.- Facilitating the payment making process for the submitted claims after reviewing the details from the contracts. Validating claims according to Policy terms and conditions. Show less

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  Noble Insurance Broker Co. LLC

  Apr 2013 - Mar 2014

  Assistant Manager Claims

  - Group Medical underwriting.- Approaching leading insurance companies for arranging quotations, meeting clients and Insurers for finalizing business deals.- Communicating with providers and Insurance companies for facilitating approvals and reimbursement claims.- Scrutinizing reimbursement claim documents before forwarding to Insurers for timely & hassle free claim settlement.- Resolving customer queries regarding approval & claims process.- Handholding with Insurers & policy holders at every stage of policy.- Monthly MIS reporting. Show less

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  Dubai National Insurance and Reinsurance (P.S.C.)

  Mar 2014 - Apr 2015

  Assistant Claims Manager

  Coordinating with TPAs for claims process Assisting claims manager in client meetings Adjudication of reimbursement claims Assist in Client and broker trainings Internal coordination for claims payments with finance

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  National Life & General Insurance Company SAOG, UAE

  Apr 2015 - Mar 2016

  Claims Specialist

  Claims processing for direct billing claims Audit of TPA claims on monthly basis Managing client queries regarding reimbursements Internal coordination with finance team for claim POs Client induction and training related to claims process.

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  Government Of Maharastra

  Mar 2017 - Mar 2020

  Medical Officer

  Worked as Government medical officer in Primary Health center

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  Reputed Insurance companies in Dubai

  Feb 2021 - Jun 2021

  LOOKING FORWARD FOR CHALLENGING ROLES IN HEALTH INSURANCE - PAYER SIDE
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  Qatar Insurance Group

  Jun 2023 - now

  Medical officer