A Dedicated, Detail-oriented personality with experience in achieving tangible results and cross-team collaboration. Proactive and excited to partner with like-minded individuals to achieve goals. Responsible, passionate about delivering outstanding quality and service. Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Claims Associate
EXOS
01.2024 - Current
Generated, posted and attached information to claim files.
Modified, updated and processed existing policies.
Negotiated claim settlements with claimants and attorneys to resolve claims efficiently and fairly.
Updated claims system to track claim status and provide relevant information to other department.
Collaborated with internal departments and external vendors to achieve fast resolution of claims.
Assisted in the development of departmental goals, contributing to increased productivity and overall success in the workplace.
Ensure fair settlement of a valid claim.
Monitor the progress of a claim.
Analyzed RI Slips for claims received from insurance companies to establish if they satisfy the policy conditions.
Claims Handler
EXOS
01.2023 - 01.2024
Communicated verification and authorization status updates with department to facilitate decision-making.
Trained new staff members in creating accurate policy slips.
Identified and reported potential fraud or abuse related to claims to protect system's integrity.
Increased departmental productivity through proper delegation of tasks and consistent monitoring of workflow progress.
Reviewed applications and supporting documents to verify claims eligibility and accuracy.
Negotiated settlement agreements to resolve disputes.
Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
Documentation - hardcopy and softcopy - for each case.
Handled claims quickly and accurately.
Enclosed all supporting and settlement documents into the system.
Projects Officer
Independent Election Commission | IPP-USAID
01.2022 - 01.2023
Manage and facilitate flow of essential information among company team members.
Maintain project calendar and milestones.
Identify trends and shifts in execution patterns to inform changes or adjustments to model itself.
Provide input for development of new resource planning tool and resourcing process.
Establish and record policies and procedures for maintaining and using tool and process, ensuring data integrity and consistent use across foundation.
Establish user’s feedback channels to allow for continual refinement of tool and process.
Update continuously training and user guide information for tool and resourcing process.
Manage, supervise and control multiple projects through project life cycle.
Created plans and communicated deadlines to complete projects on time.
Handled customer concerns and escalated major issues to supervisor.
Inspected products and services to comply with quality standards.
Enhanced working relationships by participating in team-building activities.
Troubleshot problems and diagnosed system faults.
Trainee
Fine Hygienic Holding
09.2021 - 11.2021
Trained at Health and Safety Department that follows to Risk Management Department
Education
Bachelor of Arts in - Risk Management
American University of Madaba
Madaba, MD
2021
Skills
New build projects
Microsoft Projects expertise
Problem-Solving
Time Management
Transferable Skills
Adaptability
Documentation skills
Data Integrity
Continuous Improvement
Settlement determinations
Reporting skills
Claims Investigation
Team Collaboration
Certification
Crisis Management - International Business Management Institution.
Problem Solving Skills - International Business Management Institution.
Data Quality Assessment - USAID.
Business Modelling and Financial Planning - DvCircles.