Summary
Overview
Work History
Education
Skills
Participations
Reference
Timeline
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Alhaan Faatihah Binti Muha

Claims Executive
Bandar Baru Bangi

Summary

Graduated with Bachelor of Biomedical Science from University Kebangsaan Malaysia. Experienced as Guarantee Letter Assessor and Reimbursement Claims in meticulously reviewing and evaluating medical claims to ensure accuracy and compliance with established guidelines. Possess a solid foundation on clinical laboratory and medical diagnostic with strong background in Biomedical Science, able to leverage analytical abilities and industry knowledge to continuously strive to optimize claim adjudication processes and contribute to enhancing overall operational efficiency. Seeking a career opportunity in insurance industry to fully utilizes learnt knowledge and skills gained from the experiences and assist company to achieve goals and targets.

Overview

3
3
years of professional experience
7
7
years of post-secondary education

Work History

Reimbursement Claims

Prudential BSN Takaful Berhad
12.2024 - Current
  • Adhering to the claims workflow in relation to Personal Accident and Hospitalization claims procedure.
  • Assess and provide justifiable claims according to policy terms and conditions, within the department benchmark, turnaround time and authority limit.
  • Ensure claims appeal, referral or complaint from any parties are attended to and respond within the benchmark set by the department.
  • Analyse necessary documentations such as medical reports, police reports and all investigation reports.
  • Ensure and monitor claims processing to be within the department benchmark and turnaround time.
  • Closely follow up on outstanding cases.
  • Responsible for claim settlement and ensure payments are processed within agreed turn around time.

Guarantee Letter Assessor

Allianz Life Insurance Malaysia (ALIM)
11.2023 - 12.2024
  • Manage day-to-day 24/7 operations related to guarantee facilities, focusing on hospital admission and discharge processes.
  • Evaluate and process hospitalization & surgical (H&S) claims for admission in accordance with policy guidelines within authority limit.
  • Process hospitalization admission and discharge settlement within the agreed turnaround time and service standards.
  • Analyze medical documentation to ensure accuracy and compliance with regulatory standards.
  • Implemented and adhered to data protection and confidentiality protocols to safeguard patient information.
  • Provided exceptional customer service to patients and healthcare providers, addressing any concerns promptly and effectively.
  • Assisting the Helpline team by addressing inquiries related to hospitalization and discharge to agents.

Internship Student

Institut Jantung Negara
08.2022 - 09.2022
  • Assisted in providing clinical testing and specimen analysis for diagnosis and treatment of illnesses.
  • Assisted in analyzing laboratory findings to check accuracy of results
  • Performed 473 outpatient phlebotomy for further laboratory testing.
  • Conducted blood smears in hematology section for further diagnosis.
  • Facilitated critical testing results without compromising sample validity.
  • Participated in hematology automated analyzer training by manufacturer to gain knowledge.
  • Reported back to instructor to receive day-to-day tasks and responsibilities.
  • Provided clerical support, addressing routine, and special requirements.
  • Communicated effectively with faculty and staff and accepted critiques and suggestions for areas of improvement.
  • Protected patients and employers by adhering to infection-control and hazardous waste policies and protocols.

Education

Bachelor of Biomedical Science With Honors (Hons) -

Universiti Kebangsaan Malaysia
Kuala Lumpur
09.2019 - Current

Foundation in Science -

Universiti Teknologi Mara (UITM)
Selangor
05.2018 - 04.2019

Skills

Technical:

  • Microsoft Word: Advanced
  • Microsoft Excel: Advanced

Participations

Final Year Project:
• Topic: The Impact of Carvacryl-2-Oxoethylgallate on Oxidative Stress in Doxorubicin-Induced Cardiotoxicity

Diabetes Webinar Program:

  • Secretary of the Diabetes Webinar Program
  • Managed weekly agenda and arranged new meetings and appointments
  • Preparing and disseminating correspondence, memos and forms
  • Supported and facilitated the completion of reportsBlood Donation Program:
  • Exco of Special Duties for Blood Donation Campaign
  • Assisted in setting up the venue for physicians and crews Laboratory Attachment Program:

• Participated in the Attachment Program in Hospital Canselor Tuanku Muhriz (HCTM) that exposed real-life clinical setting industry

Reference

NorHafidah Binti Mamat

Assistant Manager

Prudential BSN Takaful Berhad

0193147307

Nor.Hafidah.Mamat@prubsn.com.my

Timeline

Reimbursement Claims

Prudential BSN Takaful Berhad
12.2024 - Current

Guarantee Letter Assessor

Allianz Life Insurance Malaysia (ALIM)
11.2023 - 12.2024

Internship Student

Institut Jantung Negara
08.2022 - 09.2022

Bachelor of Biomedical Science With Honors (Hons) -

Universiti Kebangsaan Malaysia
09.2019 - Current

Foundation in Science -

Universiti Teknologi Mara (UITM)
05.2018 - 04.2019

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Alhaan Faatihah Binti MuhaClaims Executive