Experienced health insurance professional skilled in Medical/life Insurance, Risk Management, Customer Service, Pre-authorization and Team Building. Strong military and protective services professional with a diploma in General Nursing and Midwifery from India .
Hi, I’m
Shahana Ebrahim Safiya
Dubai,United Arab Emirates
Summary
Overview
16
years of professional experience
2
years of post-secondary education
Work history
SANTECHTURE DMCC
Senior Business Rules Analyst
10.2022 - 05.2023
Job overview
- Developed and executed a business rules management system for a multinational corporation, yielding a 30% boost in operational efficiency and a 20% decrease in error rate
- Spearheaded a team of analysts in conducting in-depth business rules analysis, resulting in the identification and resolution of critical issues, elevating decision-making processes and ensuring regulatory compliance
- Collaborated seamlessly with cross-functional teams to convert intricate business requirements into concise and precise business rules, fostering data integrity and mitigating risk exposure
- Conducted regular audits and evaluations of existing business rules, identifying optimization opportunities and recommending strategic changes that yielded a 15% cost reduction and streamlined business operations.
SUKOON
Senior Claims Officer
02.2014 - 09.2022
Job overview
- Assessed and processed complex insurance claims, demonstrating exceptional attention to detail and accuracy in evaluating policy coverage, documentation, and claim settlements
- Led a team of claims adjusters, providing guidance and support to ensure consistent and efficient claims processing, resulting in a 20% reduction in average claim handling time.
- Developed and implemented innovative strategies to streamline claims procedures, resulting in improved customer satisfaction scores and a 15% decrease in average time to close claims.
- Collaborated with legal and fraud investigation teams to identify and mitigate potential fraudulent claims, resulting in a 30% reduction in fraudulent payouts and significant savings for the company.
NEXTCARE
Claims processor
10.2010 - 01.2014
Job overview
- Processed an average of 350 claims per day, ensuring accuracy and adherence to companypolicies and guidelines
- Investigated and resolved complex claims, successfully identifying potential fraud andminimizing financial risks for the company
- Collaborated with internal departments and external stakeholders, such as medicalprofessionals and legal advisors, to gather necessary evidence and documentation for claimsprocessing.
Government Medical college HospitalThrissur
Staff Nurse
03.2007 - 09.2010
Job overview
- Designed and executed nursing care plans for surgical patients.
- Prepared operating room for specific surgery requirements.
- Delivered exceptional care to boost patient healthoutcomes. Administered medication with meticulous attention to detail.
Education
Jawahar Navodhaya VidyalayaKerala, India
from Science with Maths
03.2001 - 03.2003
University overview
Government School of Nursing
Pre-degree from Nursing and Midwifery
03.2007
University overview
RISC Institute DMCCDubai
from cert.CII- Award in customer care and Award in General Insurance.
10.2019 - 03.2020
University overview
Skyline Medical coding Training CenterDubai, UAE
from Cert. in Professional Medical Auditing (CPMA)
University overview
Skills
- MS office
- Data analysis
- Claims
- Reporting skills
- Prior authorization processing
- Data entry experience
- Billing cycle expertise
- Key Performance Indicator (KPI) management
- Team supervision
- Client support
- Customer relationship management
Languages
English
Fluent
Hindi
Fluent
Malayalam
Native
Tamil
Fluent
Arabic
Upper intermediate
Timeline
Senior Business Rules Analyst
SANTECHTURE DMCC
10.2022 - 05.2023
RISC Institute DMCC
from cert.CII- Award in customer care and Award in General Insurance.
10.2019 - 03.2020
Senior Claims Officer
SUKOON
02.2014 - 09.2022
Claims processor
NEXTCARE
10.2010 - 01.2014
Staff Nurse
Government Medical college Hospital
03.2007 - 09.2010
Jawahar Navodhaya Vidyalaya
from Science with Maths
03.2001 - 03.2003
Government School of Nursing
Pre-degree from Nursing and Midwifery
Skyline Medical coding Training Center
from Cert. in Professional Medical Auditing (CPMA)
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