DEMI MAE BOBIS REBADULLA
Analyst
Tanza,Cavite
Summary
Results-oriented Analyst skillful in managing and breaking down large volumes of information. Proactive at heading off issues in operations, workflow and production by uncovering trends affecting business success.
Overview
13
13
years of professional experience
14
14
years of post-secondary education
Work History
Analyst- Global Benefits Management
Willis Towers Watson
07.2023 - Current
- Implementation and Data Collection - Coordinating the GBM technology setup and tracking the initial inventory of benefit policies
- Ongoing Data Inventory - Staying on top of renewals in an ongoing basis, ensuring any troubleshooting issues are escalated - Ensuring information in Benefits Engine and Benefits Insights is complete and accurate
- Project Management - Providing internal PM support - Doing a high-level consistency review on any client deliverables and providing support in preparation of client meetings
- Pooling Support - Collecting pooling data to update Benefits Engine and reporting
- Non-specific client support - Providing support on other areas like trainings, ensuring best practices and budget management
- Enhanced team collaboration by providing clear communication of complex findings through visualizations and reports.
- Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
- Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
Operations Processing Supervisor - Accident and Health Express Claims for United Kingdom
Accenture
01.2023 - 06.2023
- Manages Teams of Insurance Claims Adjusters, First Notice of Loss administrations and users acceptance testers.
- Lead team to achieve Key Performance Indicators and ensure business compliance is met at all times.
- Document work instructions and initiates process improvements for efficiency gains.
- Leads process migrations for the team and takes part in process improvement projects outside the team scope of work.
- Monitor workload versus available resources and coaches staff on updates and process changes.
- Provide mentoring to senior staff and junior leads.
Claim Examiner - Accident and Health Complex United Kingdom
Accenture
11.2021 - 12.2022
- Process First notice of Loss
- Adjudicate claims which includes claim investigation, review of medical records and evaluate claim in a consistent and timely manner.
- Settle insurance claims, arrange payment based on the policy coverage
- Making inbound and outbound calls to claimants, medical service providers and clients.
- Other tasks: Fraud Champion, Complaint champion, Admin task which includes Start and End of day reporting, Team mailbox monitoring, Claim allocation within team members.
Auto Claims Examiner for Australia and New Zealand - Australasia
American International Group
08.2017 - 11.2021
- The primary purpose of the job is to investigate, evaluate, negotiate and settle for simple to the most complex of the AIG Express Claims cases by collecting and analyzing data according to policy application and/or contract provisions.
- Determine whether to accept or deny a claim based on all documentation received.
- Typical claims include policy coverage issue where a potential, partial or full denial is required.
- Utilizing acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing, and analyzing documentation, policy provisions and other records.
- May require additional contact with other parties (i.e. employer, claimants, third parties such as medical providers, auto repair centers, etc.) as deemed necessary.
- Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of claim.
- Providing timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquiries according to company policy and procedure.
- Maintaining accurate system data and documentation by collecting, recording, analyzing, and summarizing information.
- Determining and timely sets appropriate reserves within authority level.
- Identifying subrogation opportunities and fraud potential and make appropriate referrals.
- Providing mentorship to less tenured adjusters.
- Taking on higher complexity claims as needed.
- Additional tasks included but not limited to: Do additional tasks related to the process which includes Pfizer Monthly Claim Report and Rentokil Client Codes concerns. Consolidate end of day report. Certified Quality Reviewer both for OneView Upload Process and Expense Payment. Also, the pioneer on the migration of the above-mentioned processes.
US Claims Examiner Support
American International Group
12.2015 - 08.2017
- Assist to Adjuster request including the following: Request Policy and Underwriting file copies.
- Setting up Legal Matter and Closing out Legal Matter.
- Creating of Vendor Services Acknowledgement Letter. Division 66 Acknowledgment letter, State Compliance Settlement Letter, State Compliance Acknowledgement Letter and Healthcare Acknowledgement Letter.
- Update Suit, Arbitration and Appeal logs.
- Performing the Shared Worklist work type.
- Notice Only Request.
- Creating and Closing of Vendor Assignment and Reporting System (VARS).
Medicare Reports and MIR Traditional - US Account
American International Group
02.2015 - 11.2015
- Update Claimants general information on MMI Screen.
- Extract Alerts, Missing TPOC and Excluded Claims reports.
- Create letter for Exception report that is sent to Claimant’s Attorney (if ever available) and if not, letter will be sent to the Claimant.
Quality System Documentation Clerk
Alaska Milk Corporation
06.2012 - 01.2015
- Review and Control of Documents like Standard Operating Procedures, Formulation, Finished Product Specification, HACCP manuals for Alaska Milk Corporation.
- Conduct GMP and Hygiene Orientation for Casuals and Contractors.
- Assist on all QA related Trainings.
- Conduct Hygiene Audit for whole Alaska Milk Plant.
- Assist on all Audit activities within Alaska Milk Corporation.
Education
Bachelor of Science - Business Administration Major in Operations Management
Pamantasan ng Lungsod ng Muntinlupa
01.2008 - 01.2012
High School - undefined
Tobog High School
Oas, Albay 01.2003 - 01.2007
Elementary - undefined
Tobog Elementary School
Oas, Albay 01.1997 - 01.2003
Skills
Team collaboration
Personal Information
- Age: 34
- Height: 5'3
- Weight: 65 kgs
- Citizenship: Filipino
- Date of Birth: 05/13/91
- Gender: Female
- Marital Status: Single
- Religion: Roman Catholic
- Place of Birth: Albay
Timeline
Analyst- Global Benefits Management
Willis Towers Watson
07.2023 - Current
Operations Processing Supervisor - Accident and Health Express Claims for United Kingdom
Accenture
01.2023 - 06.2023
Claim Examiner - Accident and Health Complex United Kingdom
Accenture
11.2021 - 12.2022
Auto Claims Examiner for Australia and New Zealand - Australasia
American International Group
08.2017 - 11.2021
US Claims Examiner Support
American International Group
12.2015 - 08.2017
Medicare Reports and MIR Traditional - US Account
American International Group
02.2015 - 11.2015
Quality System Documentation Clerk
Alaska Milk Corporation
06.2012 - 01.2015
Bachelor of Science - Business Administration Major in Operations Management
Pamantasan ng Lungsod ng Muntinlupa
01.2008 - 01.2012
High School - undefined
Tobog High School
01.2003 - 01.2007
Elementary - undefined
Tobog Elementary School
01.1997 - 01.2003
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