swathi waghmare

Handle calls with client and provider Process the claims

Processed Health First insurance claims with accuracy and efficiency, ensuring compliance with healthcare policies and industry standards. Handled data entry and validation of claim details including patient, provider, and billing information. Worked across multiple claim queues including Medicare, Commercial, APG (Ambulatory Patient Group), and CV validation. Resolved claim discrepancies by reviewing policy coverage, coding, and documentation requirements. Worked collaboratively with team leads and quality analysts to meet daily productivity and quality targets. Maintained confidentiality of sensitive healthcare data in adherence to HIPAA regulations. Demonstrated strong attention to detail in identifying claim errors and initiating corrections as required.