● Open to Work

sachinkataria

Insurance Operations & Quality Lead | Claims Processing | Policy Verification | SLA & Compliance
Greater Noida West, Uttar Pradesh

About Me

Insurance Operations & Quality professional with over 4 years of experience across claims processing support, policy verification, quality auditing, regulatory compliance, SLA/TAT governance, stakeholder management, and process improvement. Experienced in Workers' Compensation claim audits, claim intake verification, coverage eligibility review, documentation accuracy, RCA/CAPA frameworks, and operational dashboards. Known for deadline adherence, quality commitment, adaptability, and collaborative delivery in fast-paced insurance operations environments.

Skills & Technologies

Insurance ClaimsWorkers' Compensation ClaimsClaims Processing SupportClaims Adjudication SupportPolicy VerificationCoverage Eligibility ReviewDocumentation ReviewRisk AssessmentQuality AuditingRegulatory ComplianceSOP AdherenceRoot Cause Analysis (RCA)CAPA FrameworksTrend IdentificationClaims OptimizationSLA ManagementTAT ManagementKPI TrackingDashboard ReportingOperational Dashboards

Work Experience

Quality & Operations Team Lead

Access Healthcare
June 2025NOW

Lead a team of 21 Quality Analysts managing 10+ core operational processes ensuring SLA compliance and on-time delivery. Directed SLA governance and stakeholder management processes achieving 100% alignment with client KPIs. Drove process optimizations via RCA/CAPA frameworks boosting operational efficiency by 15%. Developed real-time dashboards to track productivity, quality, error trends, and SLA performance enhancing leadership decision-making.

Quality Analyst

iEnergizer
November 2021June 2025

Conducted audits for Workers' Compensation claims ensuring accuracy and compliance with policies and regulations. Performed policy verification and root cause analysis to support operational improvements and mitigate claim processing gaps. Managed SLA, TAT, and client satisfaction targets maintaining 98% quality output. Processed 50+ international insurance claims daily, handling intake, documentation review, and issue escalations.

Education

Master of Business Administration

Operations & Strategic Management

IMT Ghaziabad2024 - 2026

Bachelor of Technology

Technology

Maharaja Agrasen Institute of Technology, Delhi2017 - 2021
sachinkataria - Insurance Operations & Quality | HiringAnt