Open to opportunities

Chiranjiv Waghmare

@chiranjivwaghmare

Insurance operations analyst specializing in carrier onboarding, claims workflow QA, and end-to-end client benefits setup.

India

Message

What I'm looking for

I’m looking for a high-ownership insurance operations role where I can run end-to-end workflows, improve SOPs and QA, and partner with engineering and cross-functional teams to keep high-volume processing accurate and on time.

I’m an insurance operations analyst with 8+ years across high-volume workflows—carrier connections, client onboarding, and claims processing—where I prevent downstream issues by validating details before work goes live. At Rippling, I manage 500+ global clients through benefits setup and carrier onboarding from intake to go-live, keeping accounts on track even when queue pressure rises.

My work is grounded in disciplined triage and governance: I review carrier enrollment and eligibility inputs, confirm accuracy against source records, and coordinate go-live sign-off with both carrier and client. I also run SOP updates and escalation handling so teams operate from one playbook, not scattered practices.

I’ve delivered measurable improvements through QA and training. At Genworth, I handled long-term care claims end-to-end with 97.45% audit accuracy and cut processing TAT by 15% by reworking document review sequences and updating SOPs; at Allstate, I audited 25+ claim files weekly and built training programs to help teams perform accurately under volume—not just understand rules in a classroom.

Experience

Work history, roles, and key accomplishments

Current

Senior Insurance Operations Analyst

Current

Rippling

Aug 2024 - Present (1 year 11 months)

Manage carrier onboarding and benefits setup for 500+ global clients from data intake and carrier configuration through eligibility, enrollment, document review, and go-live sign-off. Triage daily queue workload, review enrollment/coverage documentation for accuracy, maintain SOPs for onboarding/API-EDI workflows, and train 15+ CSMs to improve benefits product adoption by 20%+.

Benefits Configuration Eligibility Enrollment Document Review Enrollment File Review Effective Date Validation EDI API Output Review Go Live Sign Off Triage Process Governance Risk Management Jira Salesforce Training And Enablement Claims Onboarding Lifecycle Data Transmission Testing

Senior Claims Representative

Genworth Financial

Feb 2022 - Aug 2024 (2 years 6 months)

Handle long-term care insurance claims end-to-end from intake through settlement, including document review, coverage verification, processing decisions, issuing EOBs, and maintaining audit-ready case files. Review 120+ claim files monthly for accuracy and compliance, resolve complex escalations, and reduce document review TAT by 15% while maintaining audit readiness.

Long Term Care Claims Document Review Mid Term Adjustments Effective Date Validation Compliance TAT Tracking Escalation Management PEGA CALPSO

Trainer & Quality Analyst

Allstate India

Jun 2019 - Jul 2021 (2 years 1 month)

Audit weekly claim files and processing deliverables for data accuracy, SOP compliance, and documentation completeness, and provide corrective feedback with root-cause analysis when patterns recur. Build and run training programs for insurance workflow and QA, and translate regulatory updates into practical SOP guidance and education sessions.

QA auditing Documentation Completeness Checks Root Cause Analysis Training program development Insurance Workflows Claims Processing Regulatory Update Translation Training And Educational Sessions

Executive – Claims Operations

HDFC ERGO General Insurance

Mar 2018 - Mar 2019 (1 year)

Process 35+ claim items daily across Auto, Marine, and TPA lines by triaging, reviewing, and advancing cases while meeting SLAs and maintaining documentation quality. Review damage estimations, surveyor reports, TPA approvals, and settlement letters, and handle 40+ customer interactions per day by answering coverage questions and guiding documentation to prevent downstream settlement errors.

Claims Operations SLA Management Triage TPA Coordination Surveyor Reports Settlement Letters Policy Terms Verification Quality Documentation

Claims Trainee

Chola MS General Insurance

Jul 2016 - Feb 2018 (1 year 7 months)

Started in Motor and Health claims handling, gaining experience with intake, document review, TPA coordination, and customer queries. Built strong habits around thorough checks and keeping cases moving without letting items fall through.

Motor Claims Health Claims Claims Intake Document Review TPA Coordination Case Management