Bimal Singha
Bangalore
Summary
Come with over 19 years of experience including in compliance and regulations involved while working in Healthcare Claims & Cashless operation, Motor insurance, Provider Network Management ( Global medical Network) Training and Developing people, Recruitment etc. Passionate about facilitating compassionate and efficient solutions in challenging circumstances, I specialize in managing healthcare claims operations, developing medical networks, handling medical repatriation, and repatriation of mortal remains globally. With 16 years of experience in this field, I've developed expertise in navigating complex logistical and regulatory challenges to ensure seamless repatriation processes. Committed to providing unwavering support during sensitive situations, I have helped our clients and their families navigate these challenging circumstances with empathy and professionalism. I am looking forward to achieve and establish a career progression where I can blend my experience and align goals towards the business objectives.
Overview
20
20
years of professional experience
Work History
Assistant Manager- Claims
Mayfair We care Ltd – A Mediassist Company
05.2009 - Current
- Design and implement various policies and procedures for claims
- Provide services to all business requirements and ensure optimal handling of all reimbursement and cashless claims
- Evaluate all new claims and administer all data integrity data and manage communication to safety department and monitor all claims exceeding $5,000 and ensure timely closure
- Monitor effectiveness of all programs and provide support to all open claim file reviews and manage all payment cycle to ensure compliance to all contract requirements
- Ensures and enables claim assessors to maintain a connection with the customer by understanding and meeting their needs, serves the customer with empathy and follows up to ensure that customer needs have been met
- Co-ordinate with the various business units and recommend improvements in processes to increase proficiency and supervise effective resolution of all claim related matters and escalations
- Collaborate with team managers (Claims & Cashless) to identify operational issues, operational results, and create continuous improvement in service quality to meet client's expectations
- Review customer satisfaction results; develops and manage operation action plans Interacting with Travel Desks, HRs, Compensation and Benefits team across all clients and providing them with claims related information and address their concerns
- Overlooking Quality, Complaints and Escalations, Daily Claim & Cashless Operations
- Managed audits with Global Underwriters and have been rated as fully compliant with an exceptional rating
- Proven leadership experience with a demonstrated record of motivating and developing a high performing team
- Direct setting-up of international medical provider network directly & through various global partners
- Co-ordinate with international hospitals & global partners to arrange cashless services for insured members worldwide
- Handle Internationl Medical Evacuation ( Through Air Ambulance, Ground Ambulance) and repatriate members to a nearest countries in order to support with further medical support
- Repatriation of Mortal remains from overseas to deceased’s home country
- Being able to present the benefits and explain policy and procedures to the insured members as per their specific locations along with benefits attached to the location and other privileges which are group specific.
Claim Analyst
WNS Global Services (Being recognized as AVIVA Global Services)
02.2006 - 04.2009
- Handle Long tail Mining Claims and Industrial Disease Claims namely Vibration White Finger (VWF) and Noise Induced Deafness (NID).
Senior Process Associate
Allegianz Pvt.Ltd
06.2005 - 01.2006
- US based outbound sales campaign selling credit card processing terminals, Cheque reader and ATM Machines.
Customer Support Associate ( CSR)
Span Outsourcing
01.2005 - 06.2005
- Outbound sales pertaining to mortgage and debt consolidation.
Education
Skills
- High performance orientation
- Delegating decision making skills
- Patience in stress situations
- Producing results with appropriate decision
- Zeal for career growth
- Professional abilities
- Adopting flexibilities in working style
- Utilizing experience and knowledge
- Creativity
- Updating current events
- Strategic approach for task driven
- Working effectively with business culture
- Broad understanding of relevant processes
Accomplishments
- Recognized and given opportunities to work with various clients in overseas (Mainly Southeast Asian countries and Australia) who needed orientation on policy benefits, claims and cashless procedure, escalation matrix etc.
- Established direct billing network with esteemed hospitals worldwide and International Assistance partners who could support with cashless claims, medical evacuation and international repatriations for insured members.
Personal Information
- Title: Head- Global Provider Network
- Date of Birth: 02/27/81
Timeline
Assistant Manager- Claims
Mayfair We care Ltd – A Mediassist Company
05.2009 - Current
Claim Analyst
WNS Global Services (Being recognized as AVIVA Global Services)
02.2006 - 04.2009
Senior Process Associate
Allegianz Pvt.Ltd
06.2005 - 01.2006
Customer Support Associate ( CSR)
Span Outsourcing
01.2005 - 06.2005
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