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Mark C. — Senior Claims Analyst from Philippines

Mark C.

Senior Claims Analyst

Philippines 6+ years
Open to offersNew to Platform
Languages
English
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About

Mark C. is a detail-oriented Senior Claims Analyst with over 11 years of experience specializing in financial and healthcare insurance operations. He excels in financial data validation, payment reconciliation, claims adjudication, and ensuring compliance. Mark has proven expertise in reviewing complex financial transactions, resolving discrepancies, and maintaining data integrity in high-volume, deadline-driven environments. At Manullife Date Service Inn., he reviewed and adjudicated complex insurance claims, collaborating closely with Operations, Compliance, Legal, and Customer Service teams to resolve complex cases and improve workflows. His proficiency in Microsoft Excel aids in supporting fund migrations and optimizing financial operations. Mark also identified process improvement opportunities by analyzing claim trends and strengthening quality controls. He holds a Bachelor of Science in Business Administration with a major in Marketing Management from the National College of Business and Arts, where he was recognized as a silver medalist.

Experience

  • SENIOR CLAIMS ANALYST

    Manullife Date Service Inn. · 2019 — 2026
    Evaluated and adjudicated complex insurance claims by confirming financial transactions, calculating payments, and verifying policy provisions and supporting documents to ensure compliance and accuracy. Analyzed discrepancies in payments and denied claims, implemented reconciliations, and ensured data integrity. Collaborated with various teams, including Operations, Compliance, Legal, and Customer Service, to resolve intricate cases, enhance workflows, and ensure timely outcomes. Identified opportunities to improve processes by examining claim trends and strengthening quality controls.
  • MEDICAL ADJUDICATOR

    Manullife Date Service Inn. · 2014 — 2019
    Reviewed medical insurance claims for policy eligibility, benefit coverage, and billing accuracy, ensuring precise claim decisions. Verified payment calculations and financial details, investigating discrepancies and resolving issues in line with company policies. Maintained accurate claim records in collaboration with stakeholders to guarantee timely processing and compliance with regulations. Contributed to initiatives aimed at process enhancement by recognizing recurring issues and improving workflow efficiency.

Skills & Expertise

Education

  • Bachelor of Science in Business Administration Major: Marketing Management
    National College of Business and Arts