Eswaramoorthi sridhar

• Prepared and analyzed MIS claim utilization reports to track claim processing, trends,
and Utilization patterns.
• Generated detailed management reports using MS Excel and other MS Office packages
to support decision making.
• Extracted data from claim databases and performed data cleaning, consolidation, and
validation for accurate reporting.
• Created Dashboards and visual presentations in MS Excel (Pivot Tables, Charts, PPT) to
summarize claim utilization metrices.
• Processing Addition / Deletion endorsements in the insurer portal as per client request
(approx. 15-20 request per day.)
• Collaborated with cross - functional teams to gather requirements and deliver
customized MIS reports.
• Provided insights on claim utilization trends to assist management- in resource planning
and performance monitoring.
CLAIMS & QUERY
• Registered and processed health insurance claims accurately in compliance with
organizational and regulatory guidelines.
• Verified patient eligibility and coverage details to ensure validity for claim processing.
• Maintained up to date - knowledge of health insurance policies, coding standards (e.g.
ICD - 10, CPT) and claim submission procedures.
• Ensured confidentiality and adherence to HIPAA and other privacy regulations during
claim handling.
• Monitored Claim Status and followed up to expedite processing and payment.
• Addressed and resolved user issues escalated from query emails promptly, ensuring
timely and accurate responses.
• Categorized and prioritized query mails based on urgency and type for effective
resolution.
• Maintained detailed records and logs of query mail interactions for tracking and
reporting purposes.
• Followed up on pending queries and escalated unresolved issues to higher management
as needed.
• Improved query resolved times by identifying common issues and proposing process
enhancements.
• Utilized email management systems and tools to streamline while responding to query
mails.
• Co-ordinated with relevant- departments or teams to address and resolve customer
inquiries or internal requests.

• Ensure compliance with IRDAI and organizational policies while managing member data.