• • Reviewed and adjudicated high-volume medical pre-authorization cases against underwriting guidelines and policy
terms, maintaining a
• • Reviewed and adjudicated high-volume medical pre-authorization cases against underwriting guidelines and
policy terms, maintaining a 99.92% approval quality score
• Managed complete policy lifecycle tasks including validation, endorsements, amendments, and coverage eligibility
verification
• • Conducted rigorous case audits and documentation reviews to ensure 100% compliance with internal and
regulatory standards
• • Served as primary point of contact for customer and provider escalations, achieving consistent resolution within
SLA targets
• Partnered with claims, underwriting, and provider networks to resolve discrepancies and streamline cross-functional
workflows
• • Built and maintained KPI dashboards tracking turnaround times, service quality, and operational performance to
inform leadership decisions

• Enhanced KPI achievement across the approval team, driving consistent improvement in team-wide performance targets
• Improved approval accuracy and reduced error rate by almost 25% through ghter case review and quality control
• Improved SLA adherence and approval turnaround me by almost 40%, accelera ng case resolu on without compromising
accuracy