Anusha Surampally

Managed claimant inquiries related to settlement updates, adhering to written procedures and scripts to ensure accurate and timely email correspondence.

Processed a high volume of diverse US legal claims, including health, motor insurance, and pharmaceutical cases, demonstrating broad expertise in complex claim types.

Provided expert claims support, guiding the team in reviewing, researching, investigating, and processing complex claims to maintain operational efficiency.

Leveraged proprietary tools (Microsoft CRM Dynamics, Image Viewer, Citrix, Claim Matrix) to efficiently access, review, and process claim documents, facilitating accurate decision-making and escalations.

Adjudicated claims by approving or denying based on strict Standard Operating Procedures (SOPs), ensuring compliance and consistency across all claim types (web, paper, Defective Response).

Collaborated cross-functionally across multiple teams (AACER, Mass Tort, Correspondence, QA Escalation, Data Capture) to optimize workflows and support diverse operational needs.

Verified claim submission accuracy and validated data for entry into the adjudication system, ensuring high data integrity and compliance.

Conducted thorough research to process claims in strict accordance with established processing guidelines and benefits, ensuring regulatory adherence.

Adjudicated a high volume of claims, ensuring correct application of policies and benefits while consistently meeting production and quality targets.

Proactively worked extended hours on non-working days to clear excess claim volumes and upload batches, ensuring timely client deliverables and operational continuity.

Verified, validated, and keyed claims for contract physicians, ensuring accurate data entry and compliance with contractual agreements.

Managed the uploading and maintenance of critical provider data, including tax identification numbers, addresses, and contracts, into the insurance company's system.

Efficiently downloaded and processed provider credentialing profiles from client applications, adhering to client rules and guidelines.

Achieved timely closure of processed files, consistently meeting or exceeding Turnaround Time (TAT) targets, including prioritizing urgent files.

Mentored junior team members and trainees on claims processes, and consolidated/audited records to ensure data accuracy for internal reviews.

Prepared detailed production reports for the team and supported cross-functional needs by assisting with other processes as required, enhancing overall team efficiency.