Rummana Suhas

• Supervised and ensured the effective management of 19 member claims team.
• Carried out individual performance management with regular meetings, performance review and feedback.
• Liaised with providers and other departments regarding escalated issues.
• Identified and implemented system enhancement ideas to maximise productivity and improve the quality of adjudication decisions.

• Allocated and monitored weekly distribution of claims to team as per target.
• Trained new team members and held refresher training for current staff.
• Organized and led team meetings and team building activities.
• Verified and released processed claims and logged in errors.

• Adjudicated and processed claims within SLA and to achieve daily target.
• Managed reconciliations and further information responses from provider.
• Assisted in investigation of fraudulent claims.
• Assisted provider services in provider audits

• Research the significance and necessity of the drugs prescribed as per the disease diagnosed.
• Evaluated complex data entry, clerical and accounting tasks involved in the preparation and processing of patient insurance claims.
• Supervised releasing team with regards to productivity and efficiency.

• Taught Pharmaceutical Chemistry and Pharmaceutics
• Led various practical classroom/laboratory sessions