Underwriter Officer & Customer Service Specialist

KRISMADEL B. DELA

FUENTE

Mob: +971-*********

*************@*****.***

Personal Data

Address: Dubai, UAE

Nationality: Philippines

Language: Tagalog, English

Birthdate: 21 Dec, 1982

Skills & Job Experience

Underwriter Officer (Medical)

Senior Customer Service

Executive / Telesales

Inbound / Outbound

(Health Insurance)

Medical Claim Processor/ Data

Entry/

Competitive and Fast Learner,

Attention to details/ Pro Active

Excellent in Communication

Skills.

Computer Skills (MS Word, MS

Excel)

Knowledge in Arabic

EDUCATIONAL CREDENTIALS

- CUSTOM

ADMINISTRATION

COURSE

PMI College Philippines

OBJECTIVE

To use my knowledge and skill effectively and efficiently through ongoing learning process and to obtain a challenging position in a reputed organization. CAREER HISTORY

Adamjee Insurance Ltd. (March 2023 – March 2025)

Al Diplomacy Insurance Services (Dec -2020 to Dec 2022)

Formerly Dar Al Takaful PJSC (Jan- 2018 to Nov- 2020)

Maxcare MiddleEast TPA llc (Feb -2015 to December 2018)

Teletech Incorporated Philippines worked for 6 years

Teleperformance Philippines worked for 4 years

Telstra Pty Ltd Phil –Telco Account worked for 2 years Duties & Responsibilities

Apply various underwriting techniques and standards to ensure accurate analysis.

Accommodate and interact with the walk in clients & Direct Clients.

Handle queries from sales agent and clients. Ensure proper reports of policies.

Receive inbound calls including transferred calls from current and potential customers sales leads and process in a timely manner.

Maintain records of contact, accounts and orders.

Maintain up to date knowledge of healthcare policies and insurance regulations.

Target new customers or achieve upsells to existing customers

Place outbound follow-up calls to sales leads and persuade potential customers to complete and submit an application.

Verifying and explaining benefits, handling queries about approval follow-ups and denials, policy coverage and policy exclusions. Entry of claims and reimbursements

Initiate contact by phone with DME and pharmacy prospects and follow-up in a timely fashion

Help Customer Asses, which providers are in network and covered, to new and existing customers.

Enable to use different Insurance portals

Issuing Individual Policies as per required by clients and salesman.

Gather data to determine risk in order to scale rate and approve insurance coverage. Provide exceptional customer service to patients and address the queries effectively.

Coordinating with other departments to follow up with customer requests and to ensure timely response and to provide proper guidance on processes specifically for approvals, claims and reimbursements.

I hereby certify that all information furnished above is true and correct to the best of my knowledge and beliefs.

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