Piravina Narayani
Senior Claims Executive at Alliance Healthcare Group- Claim this Profile
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English Full professional proficiency
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Tamil Native or bilingual proficiency
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Malay Full professional proficiency
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Bio
Roshini Ramachandran
I have been worked with Piravina for 1 year, learned a lot from her. She is a person who willing to help and assist for new comers. And she also adapt to new environment and scope quit quick too. She used accept new scopes and new task assigned by team leads and manager. Her constant communication helped lift out our spirit in situations.
LinkedIn User
She is a great team player in the team and able to process claims swiftly according TAT given
Roshini Ramachandran
I have been worked with Piravina for 1 year, learned a lot from her. She is a person who willing to help and assist for new comers. And she also adapt to new environment and scope quit quick too. She used accept new scopes and new task assigned by team leads and manager. Her constant communication helped lift out our spirit in situations.
LinkedIn User
She is a great team player in the team and able to process claims swiftly according TAT given
Roshini Ramachandran
I have been worked with Piravina for 1 year, learned a lot from her. She is a person who willing to help and assist for new comers. And she also adapt to new environment and scope quit quick too. She used accept new scopes and new task assigned by team leads and manager. Her constant communication helped lift out our spirit in situations.
LinkedIn User
She is a great team player in the team and able to process claims swiftly according TAT given
Roshini Ramachandran
I have been worked with Piravina for 1 year, learned a lot from her. She is a person who willing to help and assist for new comers. And she also adapt to new environment and scope quit quick too. She used accept new scopes and new task assigned by team leads and manager. Her constant communication helped lift out our spirit in situations.
LinkedIn User
She is a great team player in the team and able to process claims swiftly according TAT given
Credentials
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Risk Management in Personal Finance
CourseraJul, 2022- Nov, 2024 -
MII Ordinary Member
The Malaysian Insurance InstituteJun, 2022- Nov, 2024 -
Value-Based Care: Reimbursement Models
CourseraJun, 2022- Nov, 2024 -
Financial Basics Everyone Should Know
LinkedInApr, 2022- Nov, 2024
Experience
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Alliance Healthcare Group
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Singapore
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Hospitals and Health Care
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1 - 100 Employee
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Senior Claims Executive
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Aug 2022 - Present
- Provide accurate and efficient adjudication of claims to meet operational and SLA targets. - Conducted regular reviews of current claims processes and worked with internal teams and clients on improved processes to improve efficiency and overall claims experience. - Managed escalations and maintain good terms with clients. - Liaise with the clients to verify exceptions as well as to resolve any complaints - Generated weekly and month-end payment reports and sent them directly to the clients. - Maintained an outstanding relationship with clients and internal teams such as the Finance team. Show less
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Cigna Healthcare Global Individuals
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United Kingdom
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Wellness and Fitness Services
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100 - 200 Employee
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Claims Representative
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Sep 2020 - Jun 2022
- Examined claims on a global scale (Asia, Africa, North America, South America, Europe, and Australia). - Assessed and processed claims for medical expenses while always bearing in mind the importance of medical confidentiality within a given processing time. - Examined claim forms to verify insurance, amounts, and currencies. - Utilized multiple processing systems (Act-isure, Salesforce, Sharepoint) to process claims. - Utilized fraud detection skills to decrease the incidence of fraud and alerted higher management if any. - Reviewed and resolved payment issues. - Meet Service Level Agreement requirements, team KPI(s), monthly quality audit scores, and NPS (Net Promoter Score). - Handle recoupment and reconciliation work, and communicate with providers and members via email for explanation and collection. Work with cross-function teams, such as Finance, CSR, Eligibility, Network, and Client Management to ensure recoupment work goes smoothly. - Organized games for KL claims team on every Thursday with Supervisor’s guidance. Show less
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Allianz Malaysia
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Malaysia
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Insurance
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400 - 500 Employee
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Claims Adjudicator
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Aug 2018 - Aug 2020
- Assessed and provided accurate adjudication of In-patient claims, validation, pre-authorization of applications, and LOG/GOP issuance to meet operational and SLA targets in line with policy guidelines. - Responsible for claim settlement and ensuring payments are processed within the agreed turnaround time and service standard. - Liaise with Call Centre/Customer Service, hospitals, agents, brokers, and third-party administrators (TPA) in the handling of GLs, and admission/discharge-related matters. - Liaise with medical doctors on medical inquiries. - Responsible for managing customer inquiries through emails/calls, and providing a response in a timely manner. - Participate in project initiatives to improve the efficiency of the current claim process and the productivity of the department. Show less
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KPJ Tawakkal Specialist Hospital
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Kuala Lumpur, Malaysia
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Clinical Laboratory Scientist
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Jan 2018 - Jul 2018
- Operated sophisticated equipment and instruments to identify the results. - Processed patient specimens according to priority and documented results. - Kept laboratory equipment clean and in good working order for optimal functionality and longevity. - Operated sophisticated equipment and instruments to identify the results. - Processed patient specimens according to priority and documented results. - Kept laboratory equipment clean and in good working order for optimal functionality and longevity.
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Royal Selangor
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Malaysia
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Retail
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100 - 200 Employee
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Customer Service Representative
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May 2015 - Nov 2017
• Hourly wages (RM 8/hour), part time worker • Provide excellent Customer Service at all times by well knowing all the products of Royal Selangor / Comyns & Selberan . • Fielded customer questions regarding available merchandise, sales, current prices and upcoming company changes. • Recommended related products to increase customer’s options and also enrich the shopping experience. • Helped customers complete purchases, locate items and join reward programs to promote loyalty, satisfaction and sales numbers. • Others ad hoc tasks assigned by superior. Show less
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Education
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2014 - 2018
City University Malaysia
Biomedical science, Biological and Biomedical Sciences -
2022 - 2022
Coursera
Insurance -
2013 - 2014
City University College of Science and Technology
Foundation degree, Sciences -
2008 - 2012
SMK Convent Jalan Peel
6A, 3B
Community
