Piravina Narayani Email & Phone Number

Johor, Malaysia

Johore, Malaysia

- Provide accurate and efficient adjudication of claims to meet operational and SLA targets.- Conducted regular reviews of current claims processes and worked with internal teams and clients on improved processes to improve efficiency and overall claims experience.- Managed escalations and maintain good terms with clients.- Liaise with the clients to verify exceptions as well as to resolve any complaints- Generated weekly and month-end payment reports and sent them directly to the clients. - Maintained an outstanding relationship with clients and internal teams such as the Finance team.

Kuala Lumpur, Federal Territory Of Kuala Lumpur, Malaysia

- Examined claims on a global scale (Asia, Africa, North America, South America, Europe, and Australia).- Assessed and processed claims for medical expenses while always bearing in mind the importance of medical confidentiality within a given processing time.- Examined claim forms to verify insurance, amounts, and currencies. - Utilized multiple processing systems (Act-isure, Salesforce, Sharepoint) to process claims.- Utilized fraud detection skills to decrease the incidence of fraud and alerted higher management if any. - Reviewed and resolved payment issues. - Meet Service Level Agreement requirements, team KPI(s), monthly quality audit scores, and NPS (Net Promoter Score). - Handle recoupment and reconciliation work, and communicate with providers and members via email for explanation and collection. Work with cross-function teams, such as Finance, CSR, Eligibility, Network, and Client Management to ensure recoupment work goes smoothly.- Organized games for KL claims team on every Thursday with Supervisor’s guidance.

Kuala Lumpur, Malaysia

- Assessed and provided accurate adjudication of In-patient claims, validation, pre-authorization of applications, and LOG/GOP issuance to meet operational and SLA targets in line with policy guidelines. - Responsible for claim settlement and ensuring payments are processed within the agreed turnaround time and service standard.- Liaise with Call Centre/Customer Service, hospitals, agents, brokers, and third-party administrators (TPA) in the handling of GLs, and admission/discharge-related matters. - Liaise with medical doctors on medical inquiries.- Responsible for managing customer inquiries through emails/calls, and providing a response in a timely manner.- Participate in project initiatives to improve the efficiency of the current claim process and the productivity of the department.

Kuala Lumpur, Malaysia

- Operated sophisticated equipment and instruments to identify the results.- Processed patient specimens according to priority and documented results.- Kept laboratory equipment clean and in good working order for optimal functionality and longevity.

Kuala Lumpur, Malaysia

• Hourly wages (RM 8/hour), part time worker• Provide excellent Customer Service at all times by well knowing all the products of Royal Selangor / Comyns & Selberan .• Fielded customer questions regarding available merchandise, sales, current prices and upcoming company changes.• Recommended related products to increase customer’s options and also enrich the shopping experience. • Helped customers complete purchases, locate items and join reward programs to promote loyalty, satisfaction and sales numbers.• Others ad hoc tasks assigned by superior.

Biomedical Science, Biological And Biomedical Sciences, 3.26

Activities and Societies: City U Badminton Club member, City U Biomedical Club memberDone 6 months internship at Lablink KPJ Tawakkal.

Insurance

Online Courses

Foundation Degree, Sciences, 3.87

Certificate attached

6A, 3B