Ujjvala Ravi Kiran

Assessed health and disability claims, and performed life claims medical assessment.

Led South Region claims and escalations across Hyderabad, Chennai and Bengaluru while managing a team of 9 doctors including OPD processors. Maintained TAT and quality processes, addressed client and broker escalations, coordinated with investigation, registration, billing and payment teams, audited claims above ₹1 lakh value, and handled insurer audits.

Processed crucial and high-value pre-authorisation claims, managed loss control activities, negotiated disputed claims, addressed queries for corporate clients and brokers, performed quality checks, and provided technical support to CRM teams.

Managed a team of doctors, processed reimbursement claims for corporate clients, addressed client and broker queries, performed quality checks, verified medical data against policy conditions, and monitored workflow and process adherence.

Processed cashless and reimbursement claims for corporate clients, provided approvals according to policy terms, assessed line of treatment, investigated suspicious claims, resolved customer and branch queries, and handled resident cashless processing at Apollo Hospitals.

Processed cashless and reimbursement claims for retail and corporate policies, assessed admission approvals and treatment details according to policy terms.

Worked across ICU, Casualty and SICU departments.

Handled patients under the guidance of senior doctors, reviewed medical reports, identified clinical problems, suggested suitable medical management, and prepared reports based on observations.

Grade: 65.42%

Completed Bachelor of Ayurvedic Medicine & Surgery (BAMS) with a GPA of 65.42%.