ABDUL EL MAKDAH
Toronto
Summary
Talented Case Manager adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life.
Overview
13
13
years of professional experience
Work History
Complex Case Manager
Workplace Safety And Insurance Board
01.2023 - 03.2024
- Accomplished Case Manager handling 50-60 new claims per month while achieving 40 entitlement decisions per week.
- Proficient in developing, implementing, and monitoring comprehensive case management plans.
- Skilled in assessing cases, setting recovery goals, and coordinating activities with stakeholders.
- Experienced in facilitating return-to-work cooperation and adjusting reintegration services as needed.
- Effective communicator, adept at educating stakeholders on benefits and processes.
- Strong advocate for client engagement, dispute resolution, and compliance enforcement.
Quality Assurance and Advisory Consultant
Workplace Safety and Insurance Board
01.2022 - 01.2023
- Conducted comprehensive claims audits to identify process improvement opportunities and cost savings
- Analyzed claims process data, identified root causes of inefficiencies, and provided recommendations to senior management
- Implemented solutions such as custom memos and letter templates, resulting in 13% reduction in processing time
- Developed and implemented process to monitor and evaluate claim decisions by case managers, resulting in 15% reduction in appeals and grievances
- Presented findings and recommendations to senior management, resulting in adoption of several key initiatives to improve claims process.
Process Design Lead
Workplace Safety and Insurance Board
06.2021 - 01.2022
- Successfully led implementation of triage system that reduced call wait times by 10% and improved customer satisfaction by 15%
- Conducted root cause analysis, executed detailed project plan, and monitored and evaluated performance of new system
- Redesigned existing process for handling first responder claims, resulting in 14% increase in decision-making
Business Process Improvement Lead
Workplace Safety and Insurance Board
01.2019 - 06.2021
- Defined, implemented, and maintained continuous improvement roadmap for process efficiencies and cost reduction
- Streamlined and standardized end-to-end business processes by eliminating barriers and waste
- Developed and implemented new two-way communication channel process for handling inquiries between WSIB and its customers
- Conducted assessment that included gap analysis and root cause analysis, resulting in 7% reduction in inbound inquiries and 15% increase in customer satisfaction.
Eligibility Adjudicator/Case Manager
WSIB
04.2014 - 01.2019
- Accomplished Case Manager handling 60-80 new claims per month while achieving 60 entitlement decisions per week.
- Proficient in developing, implementing, and monitoring comprehensive case management plans.
- Skilled in assessing cases, setting recovery goals, and coordinating activities with stakeholders.
- Experienced in facilitating return-to-work cooperation and adjusting reintegration services as needed.
- Effective communicator, adept at educating stakeholders on benefits and processes.
- Strong advocate for client engagement, dispute resolution, and compliance enforcement.
Auto Injury Claims Advisor
Desjardins Insurance
01.2011 - 04.2014
- Conduct full investigation, evaluation, negotiation, and settlement of automobile and third-party property damage claims.
- Coordinate claim investigations, collaborating with appraisers, body shops, third-party claimants, adjusters, and vendors.
- Assess liability, salvage, and subrogation exposure.
- Ensure compliance with guideline criteria and determine appropriate loss categorization.
- Maintain reserves at suitable levels based on exposure and authority levels.
Education
Bachelor of Arts - Business Economics
York University
Toronto, ON2014
Skills
- Client Relationship Management
- Project Management
- Business Process Reengineering
- Process Improvement
- Change Management
- Strategic Planning
- Problem Solving
- Quality Assurance
- Business Analysis
- Time Management
- Effective Communication
References
Available upon request.
Languages
Arabic
Professional Working
English
Native or Bilingual
Timeline
Complex Case Manager
Workplace Safety And Insurance Board
01.2023 - 03.2024
Quality Assurance and Advisory Consultant
Workplace Safety and Insurance Board
01.2022 - 01.2023
Process Design Lead
Workplace Safety and Insurance Board
06.2021 - 01.2022
Business Process Improvement Lead
Workplace Safety and Insurance Board
01.2019 - 06.2021
Eligibility Adjudicator/Case Manager
WSIB
04.2014 - 01.2019
Auto Injury Claims Advisor
Desjardins Insurance
01.2011 - 04.2014
Bachelor of Arts - Business Economics
York University
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