Atul K Verma
Medical Claims Specialist @Wellcove
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WORK HISTORY
Medical Claims Specialist @Wellcove
EDUCATION
Maharana Pratap Group of Institutions
Bachelor of Pharmacy - BPharm, Pharmacy
Subharti University
Master of Business Administration - MBA, Human Resource Management & Marketing Management
Dr. A.P.J. Abdul Kalam Technical University
Bachelor of Pharmacy - BPharm, Pharmacy, Pharmaceutical Sciences, and Administration
ABOUT ATUL K VERMA
Medical Claims Specialist with hands-on experience in US healthcare insurance claims, supporting end-to-end claims adjudication and insurance operations for Aflac-based projects.Experienced in reviewing medical documentation and policy provisions to determine claim outcomes in line with coverage guidelines and medical necessity requirements. Adept at handling complex claims scenarios including accident-related cases, duplicate claims, coordination of benefits, and documentation verification.Strong working knowledge of US health insurance processes, claim lifecycle management, and quality-driven adjudication standards. Known for maintaining accuracy, compliance, and turnaround time in high-volume operational environments.Background in Pharmacy (B.Pharm) combined with an MBA (Marketing & HR), bringing a balanced understanding of clinical concepts, policy interpretation, and operational efficiency.Actively open to opportunities in US healthcare claims operations, SPE / SDE Claims, or Claims Analyst roles, preferably in day or mid-shift environments.
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