Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Naga Bhushanam Poturi

Hyderabad,Telangana

Summary

Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach. Offering "3" years of insurance experience. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Senior Associate position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Resourceful Senior Claims Associate recognized for high productivity and efficient task completion. Skilled in claims processing, policy interpretation, and dispute resolution. Excel at communication, problem-solving, and decision-making to achieve resolutions that meet all parties' needs. Committed to continuous improvement and delivering exceptional service in fast-paced environments. Capable claims representative adept at claims investigations, information review and settlement management. Positive and reliable professional with a detail-oriented and systematic approach. Bringing several years of related experience. Skilled in handling complex insurance claims and policy processing with experience in navigating through various insurance software systems. Demonstrates strong analytical skills, adept at interpreting policies and efficiently resolving claims to the satisfaction of all parties involved. Known for maintaining high accuracy levels in document processing and data entry, contributing to streamlined operations and improved customer service outcomes. Continuously seeks ways to optimize workflows and enhance team productivity, leading to more efficient claim resolution processes.

Overview

4
4
years of professional experience

Work History

Senior Claims Associate

Carelon Global Solutions
Hyderabad
04.2023 - Current
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Analyzed and addressed escalated claims to resolve issues quickly.
  • Collaborated with internal departments and external vendors to achieve fast resolution of claims.
  • Updated claims system to track claim status and provide relevant information to other department.
  • Maintained accurate and up-to-date records of claim information for future reference.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Calculated adjustments, premiums and refunds.
  • Negotiated claim settlements with claimants and attorneys to resolve claims efficiently and fairly.
  • Generated, posted and attached information to claim files.
  • Trained new 25 FTE's on basic training.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.

Claims Associate

Carelon Global Solutions
Hyderabad
10.2020 - 03.2023
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Updated claims system to track claim status and provide relevant information to other department.
  • Followed up with customers on unresolved issues.
  • Analyzed and addressed escalated claims to resolve issues quickly.
  • Developed and implemented strategies to improve claim processes.

Education

MBA - Finance

St. Johns PG College
Chengicharla
09.2022

Bachelor of Commerce - Computers

Bhavans Vivekananda Degree College
Malkajgiri
04.2020

CEC - Commerce

Loyola Academy Junior College
Alwal
04.2017

SSC - Schooling

New Lilly Model High School
Malkajgiri
04.2015

Skills

  • Accident Investigations
  • Quality Assurance
  • Documentation Research
  • Liability Determinations
  • Billing Codes
  • Current Procedural Terminology (CPT)
  • Claims Understanding
  • Data Quality
  • Medical Claims Submission
  • HIPAA Regulations
  • Inventory Accuracy

Accomplishments

  • Successfully completed my White Belt CURES (The Enterprise Problem Solving Network) Certification.

Timeline

Senior Claims Associate

Carelon Global Solutions
04.2023 - Current

Claims Associate

Carelon Global Solutions
10.2020 - 03.2023

MBA - Finance

St. Johns PG College

Bachelor of Commerce - Computers

Bhavans Vivekananda Degree College

CEC - Commerce

Loyola Academy Junior College

SSC - Schooling

New Lilly Model High School
Naga Bhushanam Poturi