Resume CV : Insurance claim process

[Anuj.Ruhela]

RESUME :
ANUJ RUHELA
Email ID : anuj.ruhela AT icicilombard.com, anuj.ruhela AT rediffmail.com

CAREER OBJECTIVE :
1. To be a part of the organizational team and to participate actively in the team work in order to achieve the team goals and thereby organizational objectives, strategies and mission.
2. To learn continuously from the hurdles in order to convert the weaknesses into strength.

EDUCATION QUALIFICATION :
- Pursuing MBA from Symbiosis Institute of Distance Learning, Pune
- M.Com from C.C.S University, Meerut, in 2005.
- B.Com from C.C.S university, Meerut, in 2003
- Intermediate from Guru Nanak Inter College Saharanpur from U.P Board
- High school From Guru Nanak Inter College Saharanpur from U.P. Board

WORK EXPERIENCE :
AT PRESENT ICICI LOMBARD GENERAL INSURANCE NEW DELHI
Key responsibilities include :
- Handling PAN INDIA Sterilization Policy, GPA (North Region), JPA & W.C (North Region) claims process for Delhi since March 2006 to till Date.
- Helped in streamlining PA process :
- Recommended and Inserted relevant columns in PA MIS.
- Pending cases for the past one year have been resolved.
- Complete records for files being maintained from documents received to cheque dispatched.
- Sending PA MIS on weekly basis to Marketing and handling sales queries
- Box Files converted to individual files.
- Processing cases
- Sending query mails, follow up of queried cases every 15 days
- Coordination with MO’s (annexure, deficiency in claims)
- Investigation of cases (Appointment of investigator through CSM team)
- Follow up cases sent for investigation after 20 days
- File retrieval from NAX
- Sending files to NAX monthly
- Preparation of letters
- Final passing of claim
- Sending payment request to COPS
- Insight updating
- Deviation calls
- Client / Mo meetings
- Upload of master policies on insight
- Resolution of query cases in case of difference of opinion between MO/CSM and our team
- Consultation with Dr in whichever case the need arises.
- Coordination with HO/internal customers for Cheque/Fund transfers
- Report preparation / overview of claim ratios
- Publish MIS PAN India to CS & FISG fortnightly & monthly.

Office In charge – INFANT JESUS SCHOOL SAHARANPUR : April 2004 to Nov 2005.
- Maintaining Accounts of Office.
- Maintaining billing and deposited fees of Children’s.
- All office computer entries of employees and ledger Account.
- Preparing Salary and Salary Slips.
- Deposited and withdrawal cash in banks account of office.

TECHNICAL SKILL :
MS Office, Windows 95/98/2000/XP, Tally 4.5, 5.4

PERSONAL PROFILE :
Date of Birth : 06-04-1983
Nationality : Indian
Marital Status : Married
Languages Known : Hindi, English
Hobbies : Working On Computers, Music.

Place :
Date : (Anuj Ruhela)

[Guest]

R.UDAY A PRAKASH,
Email-id : udayaprakash50 AT gmail.com

CAREER OBJECTIVE :
To work in an organization with utmost sincere and to upgrade my skills along with the growth of the organization and to make a difference in what ever I do.

EDUCATIONAL QUALIFICATION :
Qualification Name of institution Board/university Year of passing Percentage marks :
B.E S.A Engineering college Anna university 2009 68
XII Sethu bhaskara higher secondary school Higher secondary 2005 73
X Model matriculation school State board 2003 63

AREA OF INTEREST :
Special electrical machines
Power system analysis

SPECIAL SKILLS :
Good communication skills
Utilizing engineering drawing
Working in mat lab

WORK EXPERIENCE :
1.July 2009 – Till Date, Golden Enterprises (Star Health and Allied Insurance), Chennai as Claims Officer.

Project/Process : TAMILNADU CHIEF MINISTER KALAIGNAR'S INSURANCE SCHEME FOR LIFE SAVING TREATMENTS

Contribution :
Validating Claims and Preauth
Verify all medical, non medical and all supporting documents required for the procedure undergone
Raise a query if any mandatory document is not produced
Follow up with hospitals through email regarding pending claim queries(if query is not replied within specific period)
5 Handle Telephone enquiries from hospitals and provide information

ACHIEVEMENTS :
Won prize at defence level concept drawing
Won prize in technical symposium
Won prize in creative works