AL Nassir
About Candidate
An exceptionally competent and results-oriented professional. With more than 15 years of experience in the uncertain and chaotic realm of insurance companies and medical providers, I am currently working as a Team Leader for an insurance network department. I am trustworthy individual who picks things up quickly, has excellent multitasking skills; well-versed in insurance and other business cultures. Totally dedicated to my work. tech-savvy and focused on efficiency. I put a lot of effort on remaining distinctive and making valuable contributions to my management team.
Location
Education
Bachelor Degree Graduate with Diploma
Bachelor Degree Graduate with Diploma
Work & Experience
esponsible for all aspects of participation in contracting with the assigned providers / insurance company
Implement strategies to accurately determine the cost of the provider and insurance
Ensure that all negotiations are in line with provider’s pricing targets, optimum services and payment terms
Carry out procedure code mapping for the contracted services with the healthcare providers as needed
Review provider dashboards and quality reports to measure provider performance and utilization
Prepare weekly action plan in managing assigned providers and provide update / status reports to the superior
Supervises contractual agreements with partner insurance and corporate companies in compliance with government and health authority
mandates
Statistical reporting and situational analysis proficiencies.
Outlines company policies in standardizing insurance network process flows
Reviewing and assessing life insurance applications
Conducting detailed medical and financial background checks
Analyzing risk factors related to age, health, lifestyle, and occupation
Determining appropriate premium rates based on risk assessment
Making decisions on policy approvals, modifications, or denials
Interpreting and applying underwriting guidelines and policies
Collaborating with insurance agents and brokers to gather additional information
Keeping up-to-date with changes in industry regulations and underwriting best practices
Maintaining accurate records of assessments and decisions
Answer customer queries via phone, email, and live chat in a friendly and professional manner.
Provide accurate product and service information to customers and assist with inquiries.
Handle customer complaints efficiently, escalating issues to the relevant departments when necessary.
Process orders, payments, refunds, and updates to customer records in the company database.
Assist with troubleshooting product-related issues and providing technical support.
Upsell and cross-sell products and services to meet customer needs.
Monitor and report on customer feedback to improve service quality.
Achieve and exceed performance targets and key performance indicators (KPIs).
