Open to opportunities

Jesintha Irene

@jesinthairene

Message

Experienced health insurance specialist with dental background.

India

Message

What I'm looking for

I seek a role in insurance claims or operations where I can leverage my 7 years' experience to improve claims turnaround, ensure compliance, mentor teams, and collaborate with hospitals in a patient-focused, process-driven environment.

I am a dedicated health insurance specialist with a background in dental surgery and seven years of professional experience in cashless and reimbursement claims processing. I am proactive, reliable and skilled at multitasking to prioritize patient and client needs.

In my current role I developed and implemented cashless processing methods, maintained mandated turnaround times (120 minutes for cashless transactions and five days for reimbursements), handled escalations, identified fraudulent cases, and coordinated negotiations with hospitals via relationship managers.

I regularly conduct audits, train and guide team members, organize meetings and prepare comprehensive reports. I focus on compliance with legal and regulatory requirements and on improving operational efficiency in claims management.

Experience

Work history, roles, and key accomplishments

Current

Cashless Specialist

Current

Confidential

Jun 2018 - Present (7 years 4 months)

Developed and implemented cashless claims processing methods, maintaining 120-minute turnaround for cashless transactions and five-day reimbursements while ensuring regulatory compliance and timely claim resolution.

Claims Processing & Compliance MS Office Auditing Fraud Detection

Reimbursement Specialist

Confidential

Managed daily employee expense and reimbursement processing, performed audits to ensure policy compliance, handled escalations and re-examinations to reduce grievances, and trained team members on effective claim processing.

Escalation Management & Compliance Reporting MS Office