Accumulated over 8 years of experience in Insurance Specialist with extensive experience in Claims management, policy administration, and process optimization. Skilled in leading teams, enhancing operations efficiency, and ensuring strict compliance with regulatory standards. Adept at handling escalations, collaborating with stakeholders and driving continuous improvements to maximize service excellence.
Overview
8
8
years of professional experience
Work History
Insurance Specialist Team Lead
Marsh McLennan
06.2023 - Current
Lead and manage a team of insurance professionals, ensuring adherence to service levels and timely, accurate resolution of claims.
Oversee workforce planning, task allocation, and workload distribution to maintain operational efficiency and meet case deadlines.
Understanding client/ Partner query/requirement on email or call and provide them appropriate solution.
Track and analyze team performance, identifying key areas for improvement and implementing targeted training interventions.
Developed and updated Standard Operating Procedures (SOPs) and Administrative Manuals, ensuring clear guidelines and consistency in operational processes.
Conducted routine audits of claims to uphold quality standards and ensure accuracy.
Coordinate with global counterparts to ensure seamless issue resolution and process standardization.
Serve as the primary liaison between internal teams, Subject Matter Experts (SMEs), and senior stakeholders to address escalations and urgent cases.
Customize reports to meet specific departmental on monthly basis.
Prepare and present performance reports to key stakeholders, offering insights into team productivity, case resolution efficiency, and ongoing improvement initiatives.
Delivered comprehensive training sessions to onboard new hires, acquainting them with diverse client requirements and protocols.
Senior Operation analyst
Sun Life Global Solutions
09.2017 - 06.2023
Ensured seamless claim approvals by integrating underwriting decisions into automated workflows, minimizing processing time and errors.
Prepared and published weekly and monthly team quality reports and Key Performance Indicator (KPI) analyses.
Coordinated with internal teams to streamline enrollment workflows and resolve discrepancies, enhancing service efficiency.
Addressed client queries related to claims benefits, eligibility, and policy changes, ensuring a smooth enrollment experience.
Maintained compliance with insurance regulations and client-specific requirements, minimizing risks and errors.
Reviewed and processed employee claims, ensuring accurate approvals or rejections based on insurance policy criteria.
Provided premium calculations and underwriting approvals, ensuring compliance with insurance policies and risk assessment guidelines.
Conducted in-depth analysis of complex and escalated cases, collaborating with clients and underwriters to facilitate resolution.
Supporting Individual insurance department in improving policy management process.
Possess extensive expertise in insurance operations, encompassing enrollment, underwriting, LTD (Long-Term Disability), STD (Short-Term Disability), and retirement plans.
Worked closely with risk and compliance teams to implement best practices and process improvements.