Shambu Moodi
Bengaluru,Karnataka
Summary
To work for an organization that provides me the opportunity to improve my skills, knowledge, and growth along with the company's objectives.
Overview
3
3
years of professional experience
Work History
Claims Associate
Carelon global solutions
Bangalore, India
01.2022 - Current
- Reviewing and adjusting the claims.
- Managed high-volume claim caseloads, ensuring accurate documentation and adherence to company policies.
- Managing high dollar claims with high quality and accuracy.
- Good understanding of the application of health process.
- Maintains records of all benefits and resolves all issues in the claims.
- Offering customer service, including explaining benefits, resolving issues, and guiding beneficiaries through the claims process.
- Good working knowledge of claims and products including the grievance and reconsideration process.
- Trained on RTM (real-time messaging), where the provider dispute will be solved immediately by connecting with benefit office agents.
Education
Bachelor of Commerce -
Shri Kumareshwara Arts And Commerce College,Hangal
09-2020
Skills
- Claims evaluations
- Claims inspections
- Secure data practices
- Claims preparation
- Claims procedures
- Claim adjudication, general inquiries
- Analyzing claims
- HIPAA regulation
- Microsoft power point
- MS word
- Critical thinking
- Leadership
- Management skills
- Microsoft excels
Awards
- Impact Award, Carelon Global Solutions, 06/12/2022, 07/10/22, 12/31/2024, 02/28/2025, 03/31/2025.
Personal Information
Date of Birth: 06/25/1999
HOBBIES
- PHOTOGRAPHY,PLAYING CRICKET, COOKING, LISTNING MUSIC, TRAVELLING.
LANGUAGES
- English, Kannada, Hindi
Disclaimer
- I hereby declare that all above-mentioned information is true and correct to the best of my knowledge.
Timeline
Claims Associate
Carelon global solutions
01.2022 - Current
Bachelor of Commerce -
Shri Kumareshwara Arts And Commerce College,Hangal
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