Jerry Thomas Mathew Email & Phone Number

United Arab Emirates

My role is to foster robust connections with health service providers, TPA, broker relationships, and our direct sales team, crafting a symphony of exceptional quality, seamless efficiency, and client-centric services. I delve into the intricacies of DOH and DHA requirements, harmonizing them with our operations to ensure meticulous compliance with health services regulations. Building upon this foundation, I cultivate strategic partnerships with health service providers, orchestrating an uplifting crescendo of claim management outcomes.Transparent communication is the key, a note of trust and confidence echoing through every interaction. I facilitate this harmony to promote cost reduction and retention. As I assess the nature and status of claims, I prioritize complexity, offering timely solutions for claim and rehabilitation management. My liaison with Third-Party Providers (TPAs) is a dynamic dance - addressing fraudulent cases while nurturing robust relationships through consistent interactions.• As a conductor of efficiency, I manage payment orders from TPAs, creating harmonious audits that resonate with the improvement of network claims leakages.• The Claims Experience Symphony flourishes under my guidance as I refine investigation, resolution, and operational procedures. Each note is orchestrated for an enhanced experience.• Challenges are opportunities for innovation. By presenting solution-focused recommendations, I amplify policy efficiency for challenging accounts, a melody of client engagement.• Guiding the Learning Symphony, I build mechanisms for ongoing education of our medical claims staff. Each note resonates with the empowerment of knowledge and expertise.• Service Level Agreements (SLAs) are my composition. From their creation for key clients to their unification across the board, I maintain a symphony of SLAs and KPIs that resonates with market standards, a testament to excellence in the medical division.

United Arab Emirates

In my role, I orchestrated the efficient workflow for direct and reimbursement claims management at a prominent Abu Dhabi-based insurance firm, like a maestro directing a symphony of seamless operations. I initiated a harmonious in-house audit under network claims, bringing forth controls via BI Tool enhancements, a melody of precision. Controls for REIMB were harmonized to prevent over-processing, each note ensuring accuracy and efficiency.Cross-workstream collaboration was my forte, ensuring the symphony of SLA adherence and KPI consistency during a merger. Managing ex-gratia and reimbursement claim data was like orchestrating a symphony, with payment details for direct billing, client appeals, and medical reimbursement claims woven into a harmonious composition across various Emirates.Verification was my precision note, as I verified customer/claimant loss claims in accordance with company policies, a testament to attention to detail. Like a conductor, I built and fostered responsive client relationships, addressing inquiries about coverage and claims, each interaction resonating with trust and assurance.Collaborating with Third-Party Administrators (TPAs), I tracked their movements and followed up on submitted claims, ensuring a harmonious turnaround time. Integration was my orchestration, as I evaluated and integrated medical work stream processes across claims, approvals, TPA management, and payment modules, each note resonating with harmony and cohesion.In the realm of optimization, I identified and proposed alternate treatments to cardholders, a melody of cost optimization and substantial claims savings. The Noor Takaful & Watania Takaful SOPs were my creation, meticulously developed through comprehensive assessment and mapping of roles, each note contributing to a symphony of merged entity excellence.

Dubai, United Arab Emirates

In the symphony of my role, I orchestrated the development of a dedicated operational team across two brands, creating a harmony that elevated member journeys and achieved cost containment outcomes. With precision, I directed the day-to-day operations of provider networks, be it through direct management or through the collaboration of network business partners and internal stakeholders.Like a composer, I gathered, reviewed, and managed accurate provider data - the notes that laid the foundation for strategic business decisions, resonating with foresight and wisdom. A collaborative and supportive work environment was my masterpiece, enhancing flexibility within the organization and creating a melody of employee satisfaction.Critical functions danced under my guidance - from network revenue to unified email management, from training to network module system management. Negotiating intricate contracts was my forte, each note of negotiation securing a harmonious collaboration with local and international medical providers and insurance companies.As an expert conductor, I provided guidance on departmental planning and the execution of long-term goals. Network standardization, provider classification, network solutions, and pivotal cost containment projects echoed through my orchestration, a symphony of strategic brilliance.• In the realm of achievements, I contributed to the successful merger and system integration, a harmonious effort that drove operational process enhancements, each note of integration enhancing our operations.• The Contract Sonata resonated as I orchestrated end-to-end provider enrollment processes, a harmonious journey of completion, accompanied by comprehensive provider training.• Neuron leadership principles were my orchestration, fostering transparent communication and continuous improvement. In the realm of customer service delivery, I collaborated closely with operations teams, a symphony of enhancement and excellence.

Dubai, United Arab Emirates

In my role, I composed a symphony of strategic relationships, fostering growth and collaboration with providers across the UAE and GCC regions. Overseas, I directed the rhythm of international contracting, orchestrating a global network strategy that resonated across borders. Supervision was my forte, overseeing training, evaluation, and staff performance. Each interaction was guided by the melody of excellence, creating a symphony of high-performance teams. I conducted the rhythm of progress, generating comprehensive reports that tracked achievements against targets, each note resonating with clarity and direction.I was ensuring seamless harmony between international providers and internal departments. This was a melody of addressing issues and crafting effective solutions, each interaction guided by expertise and collaboration.• Like a composer, I led the development of a regional international network strategy, a harmonious response to the dynamics of the market. Each note of strategy was orchestrated with foresight and precision.• Initiation was my forte, as I engaged the matrix international departments to facilitate legal contract reviews. Like a conductor of collaboration, I harmonized this engagement, creating a melody of seamless legal processes.• Operational efficiency danced under my guidance, as I proactively educated providers and executed international contracts with precision. This orchestration was a symphony of effectiveness and operational excellence.• Troubleshooting regional access gaps and spearheading provider development in UAE, Oman, Bahrain, and Qatar was my composition, streamlining network processes and infrastructures. Each note resonated with strategic insight and action.In the realm of strategic relationships, operational excellence, and international collaboration, I wielded the baton of growth and orchestration, crafting a symphony of achievement that echoed across borders and resonated with excellence.

Dubai, United Arab Emirates

In my role, I orchestrated administrative support that facilitated the seamless closure of provider contracts with local and international providers, conducting negotiations with finesse, like a maestro crafting harmonious agreements. I oversaw the administration of the capitation scheme for payers, orchestrating the development of a basic product network that resonated with efficiency and clarity.Like a conductor of communication, I liaised between UAE providers and various internal departments, addressing issues with precision and expertise. Each interaction was a harmonious note of collaboration, culminating in well-thought-out recommendations for effective solutions.In the realm of administrative excellence and provider contract management, I orchestrated a symphony of coordination, negotiation, and communication. Each note I played resonated with efficiency, clarity, and a commitment to ensuring seamless provider relationships.

Abu Dhabi, United Arab Emirates

Responsible for contract management inventory & maintenance in an accurate manner, provided orientation to Providers and ensured regular coordination with new and existing providers by furnishing training on AKIC’s Online Validation and Approvals. I delivered re-orientation to Provider, managed Contract Rates Folder: Served as a resource in all efforts to receive and manage regular feedback from provider Insurance team to ensure the provider contract & guidelines are adhered by both parties Monitored highly utilized providers on their adherence to AKIC’s provider guidelines; ensured contract rate folders consolidation and setup in a compatible, accurate, user friendly format for the benefits of other departments. Audited the providing based on utilizations, complaints and random audit. Based on a detailed and scientific analysis providing recommendation on taking provider off the network.

Dubai, United Arab Emirates

I was tasked to work in close collaboration with the network providers on their issues related to Network, Claims & Approvals, trained them on Neuron’s provider guidelines and updated Network manager on the AUH HAAD guidelines. I also assisted Network manager on management reporting for Self-Insured medical plan requirements related to provider utilization and management including end-end Provider Reconciliation

Dubai, United Arab Emirates

As an account executive I was responsible for developing Credit shield DBASE (MS-ACCESS), processing credit/loan shield claims with investigation on claims, I also coordinated with HR & PRO, prepared Monthly report and invoice with training & performance evaluation, as well as managed Customer claims service. Managed significant challenges associated with the emerging business by achieving and surpassing monthly targets and maintaining consistence success rate. Exercised hands-on approach and effective controls to ensure adequate database design and maintenance.

Dubai, United Arab Emirates

I played a vital role in the management and direct a team of more than 14 Medical and Non-Medical Staff while ensuring smooth flow of claims, from the time it reaches office till patient receiving the payment. Responsible for administrative supervision, training, audits and performance appraisals. Rendered a keen eye for details to carry on service satisfaction claims, ensured each insurance companies turnaround time (TAT) is maintained. Received referrals from physicians, hospitals, insurance companies, etc. utilized Company documentation and obtaining all necessary information for accurate claim processing. Managed simplified and effective workflows and procedures, also established quality standards, initiated audit program, weekly claim evaluation, also prepared custom-made reports for clients. Coordinated with hospitals & clinics to obtain information pertaining to claims; verified the policy documents (Table of Benefit) of insurance company. Also oversaw administrative supervision, training, audits and performance appraisals.

Dubai, United Arab Emirates

As a supervisory role under extended Warranty scheme responsible for• Receiving repair invoices from car dealers and verifying repairs are commensurate with labor and parts prior approval and finalize claim on car warranty system.• Coordinating with Service Advisors on claims with factory participation. • Assisting the customers in the warranty transfer process. • Providing analytical reports on target performances and product loss ratios for the clients, on a management as well as client based level.

Dubai, United Arab Emirates

Responsible for • Handling telephone calls. • Demonstrating positive customer service attitude/behavior. • Providing solutions related to computer hardware related issues.• Handling multiple calls and online chat related to extended warranty queries.

Master Of Business Administration - Mba, Insurance

Specialization in Risk & Insurance Management

Bachelor Of Commerce - Bcom, Business/Managerial Economics