Swati Dhas
Deputy Manager
Pune
Summary
Assisstant supporting healthcare business analysis, credit and risk work, and hospital workflow review. Contributes to vendor analysis, system integration feasibility, and data collection for operational decisions across HIS, EMR, and ERP environments. Brings insurance claims knowledge from authorization, adjudication, audit, and fraud review work in cashless healthcare operations.
Overview
21
21
years of professional experience
Work History
Deputy Manager
Fibe previously Earlysalary limited.
05.2025 - Current
- Joined as Deputy Manager
- Understanding healthcare business processes
- Analyzing technological needs of hospitals or clinics
- Leading business analysis efforts for IT/healthtech solutions
- Evaluate healthcare IT solutions (HIS, LIMS, PACS, EMR/EHR systems)
- Assist in vendor analysis and system integration feasibility
- Support data collection and analysis for decision-making (e.g., patient flow, equipment utilization, clinical KPIs)
- Department : Credit and Risk
- Designation:- Deputy Manager since May 2025 to till date
- Duration:- 26th May 2025 to till date (3 weeks)
Senior Claims Executive At Preauth Department
Mediassist Health insurance TPA pvt Ltd.
08.2018 - 10.2018
- Cashless claim adjudication with detailed Insurance policies and coverage guidelines.
- Proper evaluation of documents in view of Investigation and documentation.
- Problem-solving and decision-making for processing.
- Ensured accurate documentation, including claim forms, invoices, medical reports, and Supporting evidence, to support the claim settlement process.
- Proficient in insurance software and technology and suggest improvement if any.
- Compliance and regulatory knowledge of system and health product
Medical Advisor /GL at authorization department (CASHLESS)
MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD.
12.2010 - 02.2017
- Responsible for supporting Medical Manager in handling comprehensive medical affairs
- Handling medical queries, both externally and internally
- Act as a Medical Advisor of the organization Assist department members in training, induction and standard maintenance where necessary
- Claims management processes e.g. authorization, adjudication, verification, audit etc.
- Evaluation of Treatment & Associated Costs
- Insurance Sector experience:- Dec 2010 to till date (14 years 5 months )
Preauthorization /Cashless
MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD
12.2010 - 02.2017
- Lead and supervise a team of approx.50 Medical Executive. ii.Providing guidance and training to maximize their performance and achieve TAT and targets.
- Iii.Conduct regular performance evaluations of Team members/Team leaders.
- Iv.Manage the resolution of complex insurance claims. v. Working closely with clients, adjusters, and Legal representatives to achieve fair and timely settlements.
- Vi. Audit of daily tasks by team members and issue resolution from branches. .
- 1.Organization: - MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD
- II. Duration: - 20th Dec 2010 to 17th Feb 2017 and 10th Oct 2018 to 15th May 2025
- III. Roles and responsibilities:-
Internship
PHC, Walki, Ahmednagar
08.2005 - 10.2005
- 3 Months of experience in PHC, Walki, Ahmednagar from Aug 2005 to Oct 2005 (Internship)
Education
MBA - Operations
Dr. D Y Patil Institute For Online Learning
Pune01-2025
BAMS - undefined
S.V.N.H. Ayurved College
Rahuri, MaharashtraBAMS - undefined
S.V.N.H. Ayurveda college
Rahuri, Ahmednagar01-2004
HSC - undefined
Bhausaheb Firodiya High school
Ahmednagar01-2000
SSC - undefined
SSVM
Ahmednagar01-1998
Skills
- Hospital workflows and healthcare systems
- Claims management processes
- Authorization and adjudication
- Medical documentation review
- Provider and payer coordination
- Data analysis tools (Excel, Power BI, etc)
- Business analysis
- Stakeholder management
- Problem-solving and decision-making
- Analytical thinking and attention to detail
Hobbies
Reading Books
Listening Music
Timeline
Deputy Manager
Fibe previously Earlysalary limited.
05.2025 - Current
Senior Claims Executive At Preauth Department
Mediassist Health insurance TPA pvt Ltd.
08.2018 - 10.2018
Medical Advisor /GL at authorization department (CASHLESS)
MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD.
12.2010 - 02.2017
Preauthorization /Cashless
MDINDIA HEALTHCARE SERVICES (TPA) PVT. LTD
12.2010 - 02.2017
Internship
PHC, Walki, Ahmednagar
08.2005 - 10.2005
SSC - undefined
SSVM
HSC - undefined
Bhausaheb Firodiya High school
BAMS - undefined
S.V.N.H. Ayurveda college
BAMS - undefined
S.V.N.H. Ayurved College
MBA - Operations
Dr. D Y Patil Institute For Online Learning