RASAN JANAGAN

Home: 732-***-****

acxhgf@r.postjobfree.com

SUMMARY

Insurance claims examiner with over 18 years of experience in processing and approving claims. I am seeking a challenging position to utilize expertise in insurance processing.

EXPERIENCE

Claims Examiner: Capital One (HSBC/Household Insurance/Beneficial Insurance), Wilmington, DE 198**-****-**** (Temp), 2000 – July 2016

Claims Examiner- Critical Claims and Fraud Claims: 2013- July 2016

Took careful, deliberate determination of whether to accept, reject or suspend judgments about a claim

Careful listening and reasoning to claims

Found hidden assumptions within claims

Traced consequences of claims

Determined credibility of sources

Claims Examiner: 2003-2013

Reviewed, approved and processed claims, determined benefits due to clients, and developed action plans pursuant to the claims and client contracts while exceeding 98% accuracy level

Set up and monitored claims

Analyzed claims to make approval, denial or investigation decisions

Interviewed claimants to correct errors and rectify omissions

Investigated questionable claim issues

Verified claims with attending physicians and/or employers

Improved accuracy and processing time

Resolved problems within allowed time meeting 100% of Service Level agreement terms

Made effective contributions in operations meetings to improve processes as an active team player

New Business Coordinator: 2000-2003

Opened new insurance policies

Involved problem solving through the many different challenges that arise

Included peer management within and outside of new businesses

Came up with effective and creative solutions to problems while staying within regulatory restrictions

Help Desk Analyst: 1998-2000 (Temp)

Resolved more complex systems and application problems

Identified trends in issue reporting and came up with preventative solutions

Teller-PNC Bank: Somerville, NJ (part time) 1997-1998

Account Clerk at Tops Appliance City: Edison, NJ 1994-1998

EDUCATION

Diploma in Data Center Support- Chubb Institute, North Brunswick, NJ

Bachelors of Science in Biochemistry- University of Madras, Madras, India

PROFESSIONAL QUALIFICATIONS

Completed LOMA exams and achieved ACS and ALMI designations

Progressing towards FLMI designation

Completed a course on money laundering and prevention of ID theft

SOFTWARE AND SYSTEMS

Experienced in MS Office applications, Microsoft Outlook and Lotus Notes in addition to insurance industry/employer specific applications

TRAINING

Medical Terminology (completed 40 hours of training)

Human Anatomy and Physiology (Completed)

Insurance Fraud Training

MS Office applications, Excel both regular and advance

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