Khesika Sivarajah
Reconciliation Claims Sup
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
8
8
years of professional experience
5
5
Languages
Work History
Reconciliation Claims Supervisor
CIGNA Healthcare Services
03.2023 - Current
- Monitored team performance, enforcing compliance with corporate claims processes and procedures.
- Investigated, evaluated and adjusted multi-line claims in accordance with standards and laws.
- Cultivated productive relationships with stakeholders, facilitating claims lifecycle.
- Built talented teams of 15 internally in KL and our BPO partners externally in India.
- Enhanced team productivity by providing ongoing training and mentorship to claims adjusters.
- Implemented cost-saving initiatives that reduced operational expenses while maintaining exceptional quality of service delivery.
- Developed strategic plans for day-to-day financial operations.
- Actively closing reconciliation claims for APAC and Middle East region to maintain a good relationship with providers.
- Processing claims and assisting with financial verifications on two different platform and book of business.
- Represent the organization during provider visits.
Administrative Services Analyst (SME – Subject Matter Expert)
CIGNA International Healthcare
01.2022 - 03.2023
- Deliver accurate information and guidance related to processes/procedures/policies
- Proactively identify and recommend solutions to recurring errors and gaps; acts as a referral point for all employees
- Enhanced team collaboration by providing clear communication of complex findings through visualizations and reports.
- Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
- Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
- Developed comprehensive training materials for new analysts, improving onboarding efficiency.
- Facilitated workshops on data visualization tools, enhancing team's reporting capabilities.
Customer Advocate
CIGNA International Healthcare
01.2020 - 01.2022
- Handled incoming calls or inquiries from prospective customers or clients
- Handled confidential financial and personal information appropriately
- Handled and resolved complaints by customers on dealers’ misconducts / errors and solving the issues by liaising with clients and organizations
- Prepared Service Request (CRM) for every interaction received and compiled tracker on daily basis to monitor progress, key issues and highlight areas of concern to Account Manager
- Well versed in using mainframe, octopus (and other claim/related applications)
- Responsible for managing all claims related activities
- Utilize client relationship software (e.g
- Salesforce.com) to document client conversations
- Worked based on KPI
Sales Associate
OPPO Malaysia
01.2018 - 12.2018
- Maintained, organized presentable merchandise to drive sales
- Reached out to customers after completed sales to evaluate satisfaction and determine immediate service requirements
- Met frequently with technical, product management and service personnel to stay current on company offerings and business policies
- Implemented marketing strategies and techniques, increasing revenue and customer satisfaction
Customer Advocate
DIGI TELECOMMUNICATIONS
01.2017 - 01.2018
- Fielded customer questions regarding available merchandise, sales, current prices and upcoming company changes
- Regularly exceeded daily sales and product add-on quotas
- Responded to customer requests for products, services and company information
- Hit daily sales (activation) target according to store and personal targets
Education
Bachelors of Law (Honours) LLB -
Northumbria University
Skills
Claims management expertise
Team management
Planning and organization
MS office suite
Claims investigation and research
Claims processing
Claims auditing
Excellent communication
Decision-making
Websites
Additional Information
Willing to travel, Take ownership and accountability for resolution of complex issues and concerns at the first point of contact; long term perspective and client concerns., Regularly conduct client service/partner reviews and as a result recommend action plans to enhance the experience., Evaluated, recommended, and approve changes of forms and reports., Prepared manuals and train workers in use of new forms, reports, procedures, and equipment, accorded to organizational policy. Documented findings of study and prepared recommendations for implementation of new systems, procedures, or organizational changes.
Timeline
Reconciliation Claims Supervisor
CIGNA Healthcare Services
03.2023 - Current
Administrative Services Analyst (SME – Subject Matter Expert)
CIGNA International Healthcare
01.2022 - 03.2023
Customer Advocate
CIGNA International Healthcare
01.2020 - 01.2022
Sales Associate
OPPO Malaysia
01.2018 - 12.2018
Customer Advocate
DIGI TELECOMMUNICATIONS
01.2017 - 01.2018
Bachelors of Law (Honours) LLB -
Northumbria University
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