DATA ANAYLSIS
Abbas Alam
BPTh. Cert. CII, LSSBB, MBA (Insurance)
Dubai
Summary
Qualified and experienced Insurance Professional with over 11 years of experience in Health Insurance. Specializing in Data driven approach for improvement in Quality and process enhancement. Successfully delivering YOY savings through case management. Looking for a position where I could expand my learning and ability to do work and to gain knowledge and experience that are related to my profession to become an asset to your company. Key Strengths: Managing and Motivating Teams, Data Analysis, Six-Sigma.
Overview
11
11
years of professional experience
8
8
years of post-secondary education
3
3
Certifications
1
1
Language
Work History
Senior Claims Officer
Sukoon Insurance
Dubai
06.2017 - Current
- In-charge of Case Management outside UAE wherein I am responsible for providing pre-approvals to medical providers like hospitals emails for Outpatients and Inpatient claims outside UAE as part of case management project
- Managing regular follow-ups and co-ordination with brokers, HR of the member’s company, members and TPA
- Providing emergency approvals for Inpatient Admissions
- Coordinate between patients, and health experts to provide accurate medical services on time
- Communicate with patients and explain them medical terms, diagnosis procedures, medical tests result, etc
- Help family members in navigating through the healthcare system in their home countries
- Worked with senior management on regular basis regarding process improvement.
- Exceeded goals through effective task prioritization and great work ethic.
- Resolved problems, improved operations and provided exceptional service.
- Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting.
- Worked within applicable standards, policies and regulatory guidelines to promote healthy working environment.
- Offered friendly and efficient service to customers, handled challenging situations with ease.
- Participated in continuous improvement by generating suggestions, engaging in problem-solving activities to support teamwork.
- Participated in team-building activities to enhance working relationships.
Officer – Medical Call Centre
Dubai Insurance Company PSC
Dubai
06.2015 - 05.2017
- Providing pre-approvals to medical providers like hospitals, medical centers, pharmacies etc
- Through calls and emails for Outpatients and Inpatient claims within UAE.
- Conducting audits of direct billing claims.
- Carried out day-to-day duties accurately and efficiently.
- Developed and maintained courteous and effective working relationships.
Claims Processer
NEXTCARE HEATHCARE TPA
Dubai
01.2014 - 05.2015
- Communicated through correspondence with members and providers regarding claim payment or required information,
- Leveraged new systems and training resources to help apply claims processes and procedures.
- Reviewed outstanding requests and redirected workloads to complete tasks on time.
Senior Executive
EXL Services PVT. LTD
Noida
10.2011 - 12.2013
- Executive Clinical Resource for a US based process – Travelers’ Insurance
- Aligned organizational objectives with company mission to increase business growth and integrate work strategies.
- Led operational team in development, rollout and management of new product lines.
Education
High School Diploma -
CBSE Board
ALLAHABAD 04.2002 - 05.2003
12TH -
CBSE Board
INDIA 04.2004 - 05.2005
Bachelor of Physiotherapy (BPT) -
P.G.) Institute of Biomedical And Natural, H.N.B.GHARWAL UNIVERSITY
06.2006 - 09.2010
MBA - Insurance and Risk Management
Himalayan University
06.2015 - 05.2017
Skills
Claims management
undefinedAccomplishments
Star Employee Award - Q1 -2019 - Sukoon Insurance (Oman Insurance Company) - It was first ever Star award to given to anyone at Sukoon Insurance.
Certification
CERT. CII
Interests
LEAN METHODOLOGIES
PROCESS ENHANCEMENT
Timeline
LEAN SIX SIGMA BLACK BELT
09-2022
LEAN SIX SIGMA GREEN BELT
07-2022
CERT. CII
12-2019
Senior Claims Officer
Sukoon Insurance
06.2017 - Current
MBA - Insurance and Risk Management
Himalayan University
06.2015 - 05.2017
Officer – Medical Call Centre
Dubai Insurance Company PSC
06.2015 - 05.2017
Claims Processer
NEXTCARE HEATHCARE TPA
01.2014 - 05.2015
Senior Executive
EXL Services PVT. LTD
10.2011 - 12.2013
Bachelor of Physiotherapy (BPT) -
P.G.) Institute of Biomedical And Natural, H.N.B.GHARWAL UNIVERSITY
06.2006 - 09.2010
12TH -
CBSE Board
04.2004 - 05.2005
High School Diploma -
CBSE Board
04.2002 - 05.2003
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