BIMAL RAJ PAUDEL
Adelaide,Australia
Summary
Friendly insurance professional experienced in investigating and processing insurance claims. Hardworking and communicative individual excels at interpreting policies and negotiating payment solutions. Recognized for providing optimum service to policyholders and quickly identifying fraudulent claims.
Currently located in Adelaide but soon moving to Perth for professional and personal reasons.
Overview
5
5
years of professional experience
Work History
Claims Consultant
Allianz
02.2022 - Current
- Responding to Insured’s requests in accordance with service standards
- Proactive handling of claims portfolio end to end to ensure insured’s satisfaction
- Providing information and feedback on claims activity and developing trends to underwriters/risk assessors to enable appropriate actions to be carried out
- Setting reserves and raising payment within scope of authority, settling claims in most cost-effective manner and ensuring timely processing of payments.
- Identifying suspicious or potentially fraudulent claims, notifying Team manager, and arranging investigation.
- Resilient- able to work well under pressure and manage up to 150 claims in portfolio by processing claims in line with set procedures and policies, ensuring that claims are documented correctly, and resolved with prompt and effective outcome.
- Managing claims using appropriate external and internal specialists to achieve settlement outcome efficiently and effectively.
- Efficient at lodging, managing and resolving complaints to find resolution for insured.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
Customer Assist Consultant
Westpac Banking
07.2021 - 12.2021
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences
- Used company troubleshooting resolution trees to evaluate technical problems and find appropriate solutions.
- Skilled at working independently and collaboratively in team environment
- Self-motivated, with strong sense of personal responsibility
- Proven ability to learn quickly and adapt to new situations
- Worked well in team setting, providing support and guidance
- Managed time efficiently in order to complete all tasks within deadlines
- Demonstrated respect, friendliness and willingness to help wherever needed
- Excellent communication skills, both verbal and written
- Passionate about learning and committed to continual improvement
Store Team Member
Woolworths
09.2018 - 12.2021
- Supported customer service goals and enhanced relations through friendly, knowledgeable and positive communication
- Supported company and clients, including addressing inquiries, resolving issues and managing customer relations
- Developed and actualized customer service initiatives to decrease wait times
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Maintained general knowledge of departments to help customers quickly locate products and merchandise
- Organized and recovered shelves, put away returns and cleaned spills and messes to maintain high standards throughout sales floor
- Used cash register to tally purchases, collect payment and execute fast and friendly check-out experiences
- Interacted positively with team members and customers to promote commitment to organization's vision and values
- Communicated pleasantly and professionally when answering phones, two-way radio calls and making announcements over PA system
Head Waiter
The Family Brasserie
10.2018 - 12.2018
- Managed over 250-300 patrons on busy Fridays/Saturdays
- Supervised set up of banquet food stations and coordinated service to multiple dining areas
- Used communication and problem-solving skills to resolve customer complaints and promote long-term loyalty
- Monitored restaurant traffic across special days and seasons and designed schedules to optimize coverage
- Supervised server staff and simultaneously served personal section of tables
- Monitored dining rooms for seating availability as well as service, safety, and well-being of guests
- Shared knowledge of menu items and flavors, enabling customers to make personal decisions based on taste and interest
- Upheld high standards of professionalism when dealing with customer issues, supporting serving staff, and waiting on tables
- Maintained customer satisfaction with timely table check-ins to assess food and beverage needs
- Displayed enthusiasm and promoted excellent service to customers, successfully increasing referrals, and walk-in business
Education
M.D. - INFORMATION TECHNOLOGY & SYSTEMS
Victoria School of Technology
Sydney01.2021
Bachelor of Business Admin. - Hotel And Motel Management
NATHM
Kathmandu07.2016
Skills
- Strong Verbal and Written Communication
- Solid understanding of Allianz systems such as ACMS, Respond
- Have good grasp on Allianz ethos & values
- Efficient at communicating with Insured, loss adjuster and Authorized Third party to find swift resolution
- Customer Relationship Management
- Complex Coverage Issues
- Claim Validity Determination
- Settlement determinations
- Coverage assessments
- Insurance industry experience
- Claim Validity Determination
References
Michael Darroch
Team Manager, Customer Service
Email: Michael.darroch@allianz.com.au
Timeline
Claims Consultant
Allianz
02.2022 - Current
Customer Assist Consultant
Westpac Banking
07.2021 - 12.2021
Head Waiter
The Family Brasserie
10.2018 - 12.2018
Store Team Member
Woolworths
09.2018 - 12.2021
M.D. - INFORMATION TECHNOLOGY & SYSTEMS
Victoria School of Technology
Bachelor of Business Admin. - Hotel And Motel Management
NATHM
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