Experienced Claims and Customer Service Professional with a strong
background in insurance claims processing, adjudication, and
customer experience management. I bring over a decade of hands
on expertise in handling complex claims, verifying policy coverage,
negotiating settlements, and delivering exceptional service in high
pressure, customer-focused environments.
Throughout my career, I've worked with industry leading companies
such as QBE Group Shared Services, Manulife Business Processing
Services, and Accenture, where I developed a deep understanding
of both operational excellence and customer satisfaction.
Work Experience:
Sales support 2019 - Oct 2025
NZ LIGHT
Handled customer inquiries across phone, email, chat, and social media. Processed orders accurately and managed changes, cancellations, and tracking requests. Resolved product and service issues, escalating when necessary. Maintained up-to-date knowledge of products, services, and policies. Documented interactions in the CRM and followed up to ensure customer satisfaction. Reported recurring issues and collaborated with Sales, Logistics, and Product teams to address complex concerns.
Claims Officer -----------
QBE GROUP SHARED SERVICES LIMITED PHILIPPINES
Delivered high-quality claims service by assessing coverage and managing investigations, evaluations, and negotiations. Provided personalized support to meet internal and external customer needs, proactively identifying solutions aligned with their goals. Ensured an exceptional customer experience by building strong rapport, managing diverse expectations, and handling multiple tasks in fast-paced environments. Demonstrated empathy and professionalism in every interaction while adapting quickly to change and supporting continuous improvement efforts.
Health Claims Adjudicator -----------
MANULIFE BUSINESS PROCESSING SERVICE
Evaluated health claims by reviewing submitted information to determine coverage and payability. Entered claim details accurately into internal systems and verified required documentation, following up with providers or customers when needed. Processed claims in compliance with policy terms and company procedures, referring cases for further review to ensure accurate decisions.
Claim Analyst -----------
ACCENTURE
Managed liability claims from initial review through final resolution, ensuring timely and accurate processing. Verified and updated claim information to maintain data accuracy, and reviewed insurance policies to determine coverage and eligible charges. Reconciled adjuster estimates to ensure alignment with policy terms and claim details, and negotiated payments with involved parties to reach fair and efficient settlements.
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Verified
