MUDDASSIR TANWIR
Cambridge,ON
Summary
Policy professional, well-versed in policy development and analysis, with commitment to achieving impactful results. Proven ability to collaborate with cross-functional teams to drive policy initiatives. Known for adaptability and reliability in dynamic environments, with strong skills in research and stakeholder engagement.
Overview
17
17
years of professional experience
1
1
Certification
Work History
POLICY OFFICER
Saudi Enaya Cooperative Insurance Company
10.2020 - 03.2024
- Review all the enrollment/application forms to ensure they are complete and meet regulatory requirements.
- Enter all data in Toshfa system for policy and endorsements issuance within department's quality standards.
- Issue policy documents and invoices for the Beneficiaries and dispatch as per agreed SLA
- Ensure that all Enrollment/Application documentation is filed and stored in the dedicated manual and/or electronic retrieval system
- Action all requests for new and renewal within the agreed SLAs
- Assist internal/external customer's queries
- Assist other member of the medical team in dispatching documents if required
- Ensure that all members upload data to the CCHI (Council of Health Insurance) portal and got approved
- Make sure to delete the rejected members Toshfa system and CCHI
- Any other task as assigned by direct Manager or department Manager
CLAIMS OFFICER
Saudi Enaya Cooperative Insurance Company
09.2013 - 10.2020
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Evaluated and settled complex insurance claims in strict timeframes.
- Achieved quick resolution of outstanding issues by conducting thorough follow-ups on pending claims.
- Ensured timely payments to policyholders by efficiently managing a high volume of claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and CCHI regulations.
Medical Claims Processor
Saudi NextCare (TPA)
09.2010 - 05.2013
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Researched and resolved complex medical claims issues to support timely processing.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Claims Adjuster
Mednet Gulf (TPA)
06.2007 - 07.2010
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and CCHI regulations.
- Managed large volume of medical claims on daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
- Generated reports on medical claims processing activities and results.
- Verified patient insurance coverage and benefits for medical claims.
Education
Bachelor of Science - Information Technology
Sikkim Manipal University
Jeddah, Saudi Arabia04-2014
High School Diploma -
Pakistan International School Jeddah
Jeddah, Saudi Arabia01.2007
Skills
- Data management and archiving
- Document organization
- Skilled in Microsoft Outlook communication tools
- Timesheet management
- Policy analysis
- Influencing skills
- Improvement strategies
Accomplishments
- IFCE (Insurance Foundations Professional Exam) Certified from THE FINANCIAL ACADEMY SAMA
- MICROSOFT EXCEL trainings
- Anti Money Laundering Certifications
Languages
English
Professional Working
Urdu
Native or Bilingual
Arabic
Professional Working
Hindi
Professional Working
Valid Driving License
Valid G license, own car available
Certification
- Certified IFCE (Insurance Foundations Professional Exam), from The Financial Academy SAMA 2021
- Microsoft Excel Training - 2014,2015,2017
- Anti Money Laundering Certificate - 2015
Timeline
POLICY OFFICER
Saudi Enaya Cooperative Insurance Company
10.2020 - 03.2024
CLAIMS OFFICER
Saudi Enaya Cooperative Insurance Company
09.2013 - 10.2020
Medical Claims Processor
Saudi NextCare (TPA)
09.2010 - 05.2013
Claims Adjuster
Mednet Gulf (TPA)
06.2007 - 07.2010
Bachelor of Science - Information Technology
Sikkim Manipal University
High School Diploma -
Pakistan International School Jeddah
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