Michelle Ng Suet WeiNo. 2, Jalan Senohong 4,Taman Cantik,56100 Kuala Lumpur+6(0)12 6656960 michellensw84@gmail.com

Personal ParticularsDate of Birth : 12 April 1984 Nationality : Malaysian Gender : Female

Education Background

Highest Education (2005–2007):University : Universiti Tunku Abdul Rahman, SetapakLevel : Bachelor of Science (Hons) Field of Study : BiotechnologyGrade : First Class HonourCGPA : 3.60

Second Highest Education (2002-2003):School/ Institute : Sekolah Menengah Kebangsaan Datok LokmanLevel : STPM Field of Study : ScienceCGPA : 3.0000

CAREER PROFILE

Seeking to Transfer Broad-Based Skill Set, 8 years of Experience in Claims Handling, Leadership, Insurance and Customer Service.

Results-focused, quality-driven professional with extensive experience in Claim, Customer Service and Insurance. Demonstrate consistent achievement of objectives and dedication towards organizational goals.

Work Experience

Past HistoryCompany Name : Great Eastern Life Assurance (M) BerhadPosition Tittle : Claims OfficerSpecialization : Assess claims in major and minor casesIndustry : InsuranceDate Joined : 2008 - 2010

Job Summaries To timely perform and process claims assessment to ensure the decisions arrived at are

in accordance with the stipulated rules, regulations and the overall Company's claims guidelines.

To meet, monitor and maintain all the productivity, standards and cycle time criteria for the processing of the claims.

To assess and approve claims promptly and accurately according to the policy provision and adhere strictly to authorized claims approval limits.

To handle correspondence, drafting letters of advice and rejection. To respond all feedbacks/ enquiries within pre-set timelines. To clear all outstanding cases within pre-set timelines by attending to at least 50 cases

per week. To prepare and present Claims Committee cases within pre-set timelines. To perform quality review for at least 100 (mixture of major and minor claims) of the

overall assessed cases by peers from other teams. To engage or deal with external professionals reinsurer, investigator, police officer, legal

representative and official bodies. To maintain the ISO certification and improve on any other aspects of the department’s

quality and standard.

Company Name : AIA Share Service Malaysia

Position Tittle : Senior Claims SpecialistSpecialization : Reporting, Assess claims in minor casesIndustry : InsuranceDate Joined : 2010 - 2012

Job Summaries To ensure Team processes all Life and/ or A&H claims as per stipulated requirements. To monitor & maintain Team to meet agreed KPIs & SLAs in aspect of TAT, quality &

productivity. To conduct technical/ soft skills training for team member when required (etc: team

briefing, update claims practice log). To coach and train new team member when required (etc: cross training, classroom

training, trainee + trainer mapping, training schedule, training materials). To ensure internal & external audit compliance with BCP. (etc: call tree, BCP evaluation

report, business impact analysis) To monitor daily work queue closely (etc: cases distribution, update case management

log). To review/ approve cases that exceed subordinates’ authority (etc: higher approval,

reversal, DMSK2000, manual settlement, NCB claw back, credit to future premium account).

To participate in new migration process for workflow re-engineering & system enhancement. (e.g.: touch time, share point, new products, fax enquiries, appeal cases, AMR benefit review project, letter handling).

To manage customer complaints within TAT agreed by business partner. To monitor daily attendance, absenteeism and attrition ratio within the Team (etc: leave

planner, attendance interview form). To gain/ upgrade multiple claims type authority limits (Hong Kong + Macau). To evaluate Team performance appraisal on mid-year & year-end basis (etc: staff

confirmation appraisal, recommendation for staff upgrade claims authority, recommendation for staff promotion & salary adjustment).

To coordinate & maintain relationship with Business Partner (etc: conference-call, email coordination, office visit trip).

To ensure reporting tasks/ assignment deliver on defined timeline (etc: decline_pending report, C30 report, OT tracker, trainee weekly tracker, AMR claim control report, aging report, daily forcible report, staff incentive report, daily audit pending, monthly audit report – internal & external + quality call centre follow-up log + quality claim cheque return log + overpayment log + quality CS problem log, dashboard, management & productivity report, daily claims notification, call centre log, system error log, review + appeal cases log).

Company Name : MCIS Zurich Insurance BerhadPosition Tittle : Assistant Manager, Life Claims Division

Specialization : Administration, Reporting, Major & Minor Claim AssessmentIndustry : InsuranceDate Joined : 2012 - 2013

Job Summaries To ensure Team processes claims as per stipulated requirements. To monitor & maintain Team to meet agreed KPIs & SLAs in aspect of TAT, quality &

productivity. To conduct technical/ soft skills training for team member when required. To coach and train new team member when required. To review/ approve cases that exceed subordinates’ authority (major – death, living,

total & permanent disability, minor – hospital & accident, medical – medical card, terminal – annuity & maturity).

To participate in new migration process for workflow re-engineering & system enhancement (etc: NLC system, LIAS system, claim form review, claim guideline review, claim process workflow).

To manage and resolve complaints cases from policyholder, FMB, BNM and consumer association.

To monitor daily attendance, absenteeism and attrition ratio within the Team. To ensure reporting tasks/ assignment deliver on defined timeline (etc: outstanding

aging report, claim ratio report, paid claim – policy reserve report, claim intimation/ registration report, ISM report).

To engage or deal with agent, hospital/ clinic, external professionals reinsurer, third party administrator (Asia Assistance Network), private adjuster, police officer, legal representative and official bodies.

To maintain the ISO certification and improve on any other aspects of the department’s quality and standard.

To participate in Personal Data Protection Act (PDPA) project (etc: review claim form & authorization/ consent letter).

To coordinate with Compliance Department on claim procedures, guidelines & complaints.

To provide personal consultation/ interview with staffs on works related issues. To review appeal claims, court cases and coordinate with relevant parties. To prepare and present Claims Committee cases within pre-set timelines.

Current EmploymentCompany Name : Prudential BSN Takaful BerhadPosition Tittle : Manager, Claim Division

Specialization : OperationIndustry : InsuranceDate Joined : 2013 till date

Job Summaries Operational - to deliver operational efficiency for claims

Delivery to meet SLA internally and externally measurement (etc: productivity, TAT, pender)

Actively monitor to complete task within assigned duration (etc: Legal/ UW / CES / CS/ Actuarial/ Finance).

Financial - to effectively managing loss ratio Regularly review and monitor the following watch-list on a monthly and

quarterly basis: Agent, Doctor, Hospital, Customer Actively investigate to capped Fraud/ Non-Disclosure at a hit rate of X% against

total Claims case volume. Effectively assess all incoming bills & invoice to avoid abuse & Fraud : capture

itemized bill, doctor's fee, hospital & clinic name, surgery/procedure fee Coach & monitor the team to achieve 100% accuracy with no financial error. Identify, assess and report the potential risk involved during claim processing

inclusive major non-compliance. Conduct effective Quality check, keep a record of Quality performance and

conduct monthly briefing to Team Customer Service - to provide competitiveness and service excellent.

Conduct workshop/TTT/Claim clinic to all region twice a year, collect customer feedback for analysis and improvements.

Set up an initiative of encouraging customers to take up e-Credit facility. People Management - manage effectively on Claims Team Resource Development,

Successor's Planning at all levels and Staff Enrichment Program Accountability in staff development by providing internal training plan or

refresher training and continuously giving technical advice, leadership and motivation whenever required.

Team Successor planning Cross training to all assessor in various claim type (etc: major & minor) Participate/ Lead in staff activities programs planned by internal or external

committee to induce better work environment / staff enrichment Strategic - innovation and process reengineering in Claims (on process improvement

and system enhancement) Effectively review existing claims practice every quarterly to HOD for

discussion and implementation by team.

System enhancement Customer portal and Client ID Decline SMS to customer Letters/Correspondences ( as and when required)

GST E- credit RIE Initiatives & Medical Strategy (Single screen validation, enhanced

In Hospital Expenses Field to cater itemized receipt item, add Doctor's field to capture name and fee charged, MMA fees and Medical Cover SL field enhancement)

Projects - Regional Claims System Product migration (New and Day 2 Projects)

Ummahlink Major Hospital Benefit Lite Platinum

Reporting – responsible in preparing daily, monthly and ad-hoc statistic/ analysis to management

Daily dashboard (TAT, Productivity, Penders) Monthly dashboard Finance report (Claims Registration, Claims Paid, Admit, Pending but not Paid,

Manual Claims Report, Late Death Compensation, Finance score card) Partnership report Retakaful recoveries Trends Report Claims Bulletin Claim Committee Updates Productivity Bonus Updates Contributor Report AML report Analysis on Top 10 Illness Decline Ratio Ex-gratia claim Claim Budget/ Cost Saving

Ad-hoc tasks Review on re-underwriting process flow for claims involve non-disclosure or

fraud Revised Medical Referral Flow – in house doctor with summary and chronology

sheet Claims Speaker in induction Program for Claims Introductory Play role as Risk Coordinator - identify, assess and review significant

department risks, and maintain quarterly Departmental Risk Register (DRR), incident report & KRI to capture the risks, SI, SIT reporting

Attend Court Hearing for Claims dispute. Handling complaints/ enquiries from internal and external parties (eg: agent,

customer, UW, CES, Finance, Actuarial, retakaful…) Review and updates on Anti-Bribery Corruption Assessment – Compliance Dialogue with FMB on IFSA schedule 9 Review and revised on criteria set for claim contest, KPI and productivity bonus.

Regulatory Compliance Matrix Coordinator – assist department in identifying the laws, regulatory requirements and business practices that applicable to the activities within department.

Review & update Claim SOP/ UDA whenever necessary

Achievements LOMA FLMI, ALMI COMET GenRe Workshop AIMA GenRe Risk Management Seminar NICS – The Management Development Programme Boston – Microsoft Excel 2010 Intermediate & Advance Risk Coordinator Rapid Improvement Event – Claim Cohort Leadership Development Programme

Core Knowledge & Skill Areas: Ability to analyze Resourceful Noble communication skills Handle tight deadlines Visionary Customer Relations Good leadership/motivation Enthusiastic Assertive Good problem solving skills Hard working Networking with counterparts in other insurance companies Computer literature (etc: Microsoft Windows, Microsoft Words, Microsoft Excel,

Microsoft PowerPoint, Microsoft Outlook, Lotus Note, Exceptional knowledge of applications: FPMS, Life Asia, HIAS, NLC, LIAS, NCS, FTS, RCS)

References:

Name : Madam Lee Sew ChinPosition : Assistant DirectorCompany : Prudential BSN Takaful Berhad

Name : Ms. Teo Li LiPosition : Senior ManagerCompany : Prudential BSN Takaful Berhad