Senior OPD Officer
Bahrain Specialist Hospital
Total years of experience :15 years, 11 Months
Insurance claims handlers are involved in managing a claim from beginning through to settlement. Depending on their level of experience and knowledge, they may be involved in investigating potentially fraudulent claims and undertaking a range of loss adjusting activities.
Depending on your experience and level of responsibility, typical activities may include:
providing advice on making a claim and the processes involved;
processing new insurance claims notifications;
collecting accurate information and documents to proceed with a claim;
analysing a claim made by a policymaker;
guiding policyholders on how to proceed with the claim;
contacting trades people from a network of approved professionals and arranging for them to make repairs on the policyholder's property;
monitoring the progress of a claim;
investigating potentially fraudulent claims;
identifying reasons why full payment may not be made;
ensuring fair settlement of a valid claim;
building relationships with loss adjusters, forensic accountants and solicitors, as well as other legal/claims professionals;
ensuring the customer is treated fairly and that the customer receives excellent service in accordance with industry and company guidelines;
handling any complaints associated with a claim;
involvement in loss adjusting activities and in legal discussions relating to settlement;
seeking legal recovery of monies paid out;
managing a team of claims handlers (at managerial level);
taking responsibility for productivity and profit;
adhering to legal requirements, industry regulations and customer quality standards set by the company.
•Interface the Patient quires and issues
•Ensure systems integrity of mainframes through proper operations and troubleshooting
•Address a complexity of issue requiring immediate attention and resolve.
•A/R Finance for Aging Reports
AIMMS
✓ VU University Karachi Sep - 2006 • I have completed Bachelor of Commerce Degree
✓ Al - Najoom International School - Jeddah • General Certificate of Education (Ordinary Level) - 2000 Economics, Business Studies, Accounts. 6.0 COMPUTER SKILLS Microsoft Word, Open Office, Excel, and Access Internet Quicken Operating System of Waseel, Bupa, Gulfunion, Globmed, Sabic, CARS, Total Care 7.0 AWARDS & MERITS ● Candidate for Employee of the Month-Saudi German Hospital Group-Jeddah (Finance Dept) as Billing Officer- 8.0 OTHER ACTIVITIES