Manager Assistant

Rona Khaled

Mobile : 009**-**-*******.

E-mail : add0at@r.postjobfree.com.

OBJECTIVE

Looking for a commendable position in a thriving company where the job involves innovative and creative approaches to develop strategies and reach long term career objectives.

EXPERIENCE:

CLAIMS ADMINISTRATION LIFE AND MEDICAL DEPARTMENT AL KHAZNA INSURANCE COMPANY DUBAI:

APR 2016 - JUN 2020:

Responsibilities Include:

Daily batching, and uploading (for E-claims and PBM) and follow up the distribution claims with auditors and with our Claims Assistant Manager to find the urgent claims to be processed.

Receive processed claims from auditors, prepares and issued these claims (batches ) as credit notes on the system to be signed by the Head of Department; arrange it through excel sheet then send it to Finance Department and Claims Assistant Manager by mails and they will received from courier .

Collect all zero batches amounts from Auditors and send it to our Claims Assistant Manager to close it on our system. (Reimbursements, E claim and Manual claims).

Follow up the claims through DHPO daily.

Coordinate with my auditors’ team and follow up their claims daily.

Uploading all the RAs for credit Notes and rejection claims.

Solving the issues uploading RA s for provider claims.

Follow up and contact with all providers by Calls and Mails (pharmacies, Medical Centers, hospitals and laboratories),and (DHA,MOH), to update the status for the reasons rejection their claims, then coordinate with our Assistant Manager to take approval from her if we can reprocess or not and make discussion about the status claims.

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Receive (Manual Claims Hard copies and Reimbursements claims) from broker and provider, to create batch number manually and enter all the details on the system then save it through excel sheet to arrange to our approvals department then finance department if its accepted.

Follow up my emails and communicate with (finance department) continuously for the providers payments.

Coordinate with providers if there is any Bank Account Issues to contact with our Network Department, and solve it.

Contact with Network department to update me the expired sender ID on the system for providers and contact with them.

Creating batch number on the system for E-claims and PBM claims in case I receive it without batch number only for (correct claims).

Verify the status for each claim that I receive it from providers like (Fraud provider, block account, duplicate claims) to create separate excel sheet and make discussion about it with my assistant manager.

Help and contact with Abu Dhabi Branch to issued their claims on my system, and coordinate with them.

Working with approvals section in answering phone calls from clients/members/brokers pertaining to the member’s policy coverage and other queries whether in Arabic or English Language.

Performs other functions that may be assigned by the Claims Assistant Manager / Head of Department and applied.

CUSTOMER SERVICE LIFE AND MEDICAL DEPARTMENT AL KHAZNA INSURANCE COMPANY DUBAI:

Handle and accepts all the medical and life risks, perform and assess several tasks for approval whether in Arabic and other patients calls and claim section, organize my time to accomplish my works in both departments(Approval and Claims Finance Department)).

Responsibilities Include:

Assist approvals department to handle and answering a lot of Arabic and other patients calls to inform them about their cases and some procedures covered or not covered depend on their policy treatment.

Follow up approval cases through emails, online portal and PBM to revise with medical centers, hospitals and pharmacies and discuss about it with our Doctors in approval team like if it’s required more justifications for inpatient cases need it from hospitals.

Working as a call center in approval team to answer on the queries and provide them information’s and services for patients (Arabic and others nationalities) like coverage ( hospitals/medical centers /pharmacies and Laboratories)

Handle a lot of calls from hospital medical centers and pharmacies to contact with our network department until to fix the problems through online portal and PBM.

Keep merchandise area tidy.

Customer Service Executive BELHASA GROUP - Dubai

JAN 2012 – FEB 2013:

I worked customer service in BEL HASAH Group Driving Center in Dubai -Al WASEL BRANCH, ZAYED UNIVERSITY, NAD Al-HUMOR and JABEL ALI.

Responsibilities Include:

Respond promptly to customer inquiries.

Handle and resolve customer complaints.

Follow up on customer interactions.

Record details of actions taken.

ACADEMIC EDUCATION :

2014 - 2018 - (American College Dubai), BBA Bachelor Business Administration.

2014 - (American College Dubai), for IELTS got 5.0 GPA Certified in British Council in Dubai.

2013-2014 (New Admin Institute), Training in English Language Courses.

2012- 2013 (New Admin Academic College), ICDL International Computer Driving License .

2012-2013 UAE Driving License.

2011-2012 DUBAI High School Graduation.

TECHNICAL EXPERTISE:

Microsoft Office Applications (:( PowerPoint, Microsoft word, Microsoft office Access, Microsoft office Excel, Microsoft Outlook).

And I have experience in the programs, Excel, and access lists very well in section MARKETING RESEARCH in the company TNS, Also in the Programs of the Quality Insurance.

SKILLS:

Ability to adapt to new environment

Deadline-driven

Enthusiastic team player

Initiative

Dynamic

Proactive

Self-motivated

Problem solving

Flexibility

CAREER OBJECTIVE:

To achieve and self-demonstrate.

Work to serve the country.

Independence Financial

Hobbies :

Working on the Programs Computer.

Reading and Writing stories.

And work relied on the responsibility of myself.

Take and learn more experiences in my life in many fields.

PERSONAL DETAILS:

Country of Birth : (United Arab Emirates) – (DUBAI).

Date of Birth : 13th Dec 1994.

Nationality : Syrian

Languages Proficiency: English, Arabic

Visa Status : On My Father Sponsorship.

Driving License : Yes (Dubai).

Sex : Female

Marital Status : Married.

Degree 1: IELTS from the American College In Dubai. (ACD).

Degree 2: ICDL Computer in all programs from the academy (New Admin Institute).

-For any queries on my CV please contact with me don’t hesitate:

Phone Number: 009**-**-*******.

Email: add0at@r.postjobfree.com.

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