Health Insurance and Property and Casualty Claims Manager

Role and background

As a health and property and casualty insurance manager, I handle the entire claims processing cycle, policy underwriting, and the management of healthcare provider networks. With extensive experience in contract compliance analysis, meticulous review of medical bills, and cost control, I combine rigorous auditing with high-quality service for policyholders. Ready to hit the ground running, I provide European industry players with rigorous management of reimbursement flows and seamless claims processing in accordance with the most demanding standards.

Professional Experience

Client Manager

June 2026–July 2026 • SEMAD Toamasina (General Agent for the SanlamAllianz Group) • Madagascar

Advised clients by accurately identifying their needs in order to offer them tailored insurance solutions. Drafted auto, travel, and student and school liability insurance policies in accordance with established procedures. Compiling and processing application files by gathering the required supporting documents before submitting them for a final decision. Ensuring rigorous administrative follow-up of files and verifying compliance with the terms of the purchased coverage when reported events occur. Optimize service quality and customer satisfaction through smooth, accurate, and responsive handling of requests.

Service Provider Coordinator

April 2025–November 2025 • MCI Care / SanlamAllianz Insurance Group • Madagascar

Managed and coordinated the network of healthcare providers to ensure high-quality service and foster long-term relationships based on trust. Handled complaints and effectively resolved daily operational issues to ensure a seamless care journey. Rigorous monitoring of contractual compliance, ensuring strict adherence to negotiated fee schedules and agreed-upon response times. Proactive identification and resolution of anomalies, including cases of overbilling, delays in coverage, and administrative non-compliance. Directly contributing to the control of healthcare costs, thereby protecting the insurer’s financial stability while safeguarding the interests of policyholders.

Claims Manager

November 2019–April 2025 • ASCOMA Madagascar • Madagascar

Oversaw the investigation and settlement of health insurance claims in strict compliance with contractual terms, deadlines, and applicable legal frameworks. Handled the analysis of claim compliance, the calculation of benefits, and the rigorous tracking of reimbursements. Seamless and continuous coordination between policyholders and partner companies, ensuring personalized support, clear information, and efficient resolution of claims. Optimized processing times through methodical workflow management and proactive communication with all stakeholders.

Intern – Administrative Sales Agent

March 2018–March 2019 • TOTAL Madagascar • Madagascar

Rigorous management and processing of customer orders and invoicing to ensure the continuity of administrative and commercial workflows. Managed the tracking of sales files, updated databases, and verified the compliance of supporting documents. Coordinated daily with internal teams and partners to optimize processing times and respond effectively to requests. Actively contributed to improving the reliability of administrative operations and maintaining a smooth and professional customer relationship throughout the sales cycle.

Training in Management Accounting

June 2017–August 2017 • BASAN Group • Madagascar

Acquired and strengthened fundamental skills in management accounting through the study of budget management and financial analysis processes. Gained hands-on experience with mechanisms for developing budget forecasts, monitoring performance indicators, and calculating cost of goods sold. Analyzed variances between actual results and forecasts to support business reporting. Developed an in-depth understanding of cost accounting flows and internal control procedures specific to the requirements of a manufacturing facility.

Intern

January 2014–March 2014 • Robert Chocolate Factory • Madagascar

Participated in daily operational activities and gained insight into the production processes specific to the industry. Supported existing teams in performing routine tasks and monitoring established quality standards. Observed and assimilated work methods throughout the production line. Contributed as needed to compliance checks and to ensuring adherence to health and safety guidelines. Completed assigned support tasks in accordance with deadlines and operational procedures.

Skills

Hard Skills: Health & Property & Casualty Claims Management, Medical Billing Audit & Review, Underwriting & Contract Compliance, Management of a Network of Service Providers, Cost Control & Workflow Monitoring

Soft Skills: Rigor and analytical precision, Focus on customer satisfaction, Proactive claims management, Interpersonal skills & negotiation, Organization and ability to prioritize

Degrees and Education

Master’s 1 in Administration, Accounting, and Finance

2017

In Progress

Bachelor’s Degree in Business Administration, Accounting, and Finance

2016

Advanced Technical Diploma (DTS) in Business Administration, Accounting, and Finance

2015

High School Diploma (Series A2)

2012

At a glance

Field of expertise

Customer service & administration

Experience

6 years of experience

Working languages

French · C1English · B2

Tools and software in use

Excel — 6 yearsOutlook — 6 yearsWord — 6 yearsISA — 5 yearsMILLIARD — 5 yearsSAP — 3 years

Markets covered

France