Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Syed Farhaan

Syed Farhaan

Summary

Medical Officer Experienced insurance specialist successful managing high caseloads in fast paced environments, organized, driven and adaptable with excellent planning and problem solving abilities, experienced for ready to take any challenges, gifted in working stressed environment. Effective at operating within regulations and department guidelines to manage calls, emails, letters, inperson request for assistance

Overview

6
6
years of professional experience

Work History

Senior Case Manager

Onsurity Technologies
05.2023 - Current
  • Streamlined case processes for increased efficiency and accelerated resolutions.
  • Collaborated with external agencies, TPA, Insurance companies, Hospitals for faster pace, ensuring optimal support and care within TAT limit.
  • Managed high-risk cases effectively, implementing crisis intervention techniques when necessary.
  • Guiding TPA doctors in case of exceptional cases or situations
  • Teamed up with managers and executives to assist in evaluating and improving performance of direct services, contributing to strategic program planning and development.
  • Presented case findings and recommendations to senior management, influencing decisions regarding client services and department operations.

Senior Associate

Go Digit General insurance company
05.2022 - 03.2023
  • Processing of Cashless, reimbursement, travel claims. Handled grievances and escalations from insured's side and delivered utmost customer satisfaction
  • Collaborated with networking department for medical treatment packages and updates, Instructing TPA's regarding claims, tracked down movement of claims of high ageing.
  • Knowledge in medical diseases and its complications of various fields followed by auditing of claims
  • ICD coding of claims in time to time basis, Self-update about IRDAI new guidelines,
  • Medical and insurance enthusiast in problem solving, engaging in hospital and insurance activities

Sr. Medical Officer

Family Health Private Limited TPA ltd
04.2021 - 05.2022
  • Communicated verification and authorization status updates with other department's to facilitate decision making for admissions and insurance coverage
  • Developed strong communication and organizational skills through working on group projects.
  • Scrutinizing claims documents and processing insurance and medical wise as per internal and policy guidelines
  • Networking of hospitals and negotiations with hospitals for fair value of hospital bills
  • Guiding CRM's, billers and CS's for tracking claims, pace moving and to build trusts with stake holders (insurers, brokers, insured)

Manager

Star Health and Allied insurance company
02.2018 - 03.2021
  • Reported policy changes, and company conditions after customer satisfaction, established positive and trusting relationships with injured clients, administrating efficient service and processing claims quickly.
  • Collaborated with inter - department's and industry anti - fraud organizations to resolve claims
  • Processing of Cashless claims with high accuracy and medical intervention
  • Followed up potentially fraudulent claims initiated by claims representatives
  • Tracked all pending authorizations to ensure timely resolution and avoid revenue loss

Education

Senior Internship -

Govt Royapettah General Hospital
Chennai

LIII -

Licentiate in Insurance Institute of India

Bachelor in Dental Surgery (BDS) - Dentistry

Ragas Dental Collage And Hospital
Chennai
10.2017

Skills

  • Negotiation
  • Grievance redressal
  • Claims review
  • Performance Tracking and Evaluations
  • Excellent verbal and communication skills
  • Claims audit
  • claims investigation

Languages

English
Bilingual or Proficient (C2)
Hindi
Bilingual or Proficient (C2)
Tamil
Bilingual or Proficient (C2)
Arabic
Intermediate (B1)

Timeline

Senior Case Manager

Onsurity Technologies
05.2023 - Current

Senior Associate

Go Digit General insurance company
05.2022 - 03.2023

Sr. Medical Officer

Family Health Private Limited TPA ltd
04.2021 - 05.2022

Manager

Star Health and Allied insurance company
02.2018 - 03.2021

Senior Internship -

Govt Royapettah General Hospital

LIII -

Licentiate in Insurance Institute of India

Bachelor in Dental Surgery (BDS) - Dentistry

Ragas Dental Collage And Hospital

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Syed Farhaan