Jeff Chen
Auckland,AUK
Summary
Experienced insurance professional with over 10 years of expertise in health and general insurance, specialising in medical claims assessment, preapprovals, underwriting, and customer service. Proven ability to exceed service-level targets, manage stakeholder relationships, and lead process improvement initiatives. Known for a professional and empathetic communication style, strong attention to detail, and a proactive, team-oriented approach.
Knowledgeable with solid background in assessing and adjudicating insurance claims. Adept at reviewing documentation and making accurate, fair decisions that align with policy terms. Demonstrated ability to navigate complex cases and maintain detailed records efficiently.
Overview
15
15
years of professional experience
Work History
Medical Claims Assessor
NIB Health Insurance
11.2019 - Current
- Assess medical claims in accordance with policy terms and conditions, meeting service-level turnaround standards.
- Provide clear and professional communication to clients regarding claims and pre-approvals.
- Collaborate with customers, advisers, and medical providers to ensure accurate and timely outcomes.
- Support risk mitigation through accurate underwriting and claims assessment practices.
- Maintained accurate records of all claims assessed, facilitating easy retrieval when needed for audits or internal reviews.
- Demonstrated consistent high performance, regularly surpassing key performance indicators and delivering exceptional outcomes.
Quality Assurance Advisor
Vero (Suncorp NZ)
11.2017 - 11.2019
- Delivered targeted quality coaching to consultants and teams, ensuring high service standards.
- Produced insights and reports on quality performance, identifying training and risk trends.
- Led stakeholder discussions on continuous improvement of the QA framework.
- Managed portfolios across Life/Medical, Domestic, and ANZ underwriting units.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
Personal Insurance Underwriter (3-Month Contract)
Vero (Suncorp NZ)
08.2017 - 11.2017
- Evaluated new and existing policies, ensuring compliance and sound underwriting decisions.
- Reviewed policy documents before issuance, ensuring accuracy and conformance to approved standards.
- Reduced claim losses by applying expert knowledge in identifying potential risks and setting appropriate premiums.
Sales Support and Underwriter ( ANZ Insurance )
Vero
11.2014 - 08.2017
- Supported ANZ bank staff and brokers with underwriting decisions and policy endorsements.
- Handled customer inquiries and policy payments, building strong client relationships.
- Documented underwriting decisions and provided evidence of compliance with applicable regulations.
- Provided excellent customer service by addressing inquiries promptly and offering comprehensive explanations of underwriting decisions.
Domestic Claims Consultant
Vero
10.2016 - 02.2017
- Managed end-to-end claims processes for house, contents, and motor claims.
- Communicated claim entitlements and managed customer expectations professionally.
- Managed large caseloads effectively, prioritizing tasks to ensure prompt attention to urgent matters.
- Provided expert advice on coverage limits and exclusions, helping clients make well-informed decisions about their insurance needs.
Escalation Manager / Business Complaints Resolver
Vodafone NZ
01.2014 - 08.2014
- Resolved high-level escalations and delivered feedback for continuous improvement.
- Provided daily insights and reports to senior leadership on complaint trends.
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
- Cross-trained existing employees to maximize team agility and performance.
Corporate and Government Case Manager (Contract)
Vodafone New Zealand
05.2013 - 08.2013
- Managed complex service cases for corporate clients across broadband and mobile services.
- Ensured all tasks met SLA targets and coordinated with suppliers and account teams.
- Resolved complex claims, utilizing expert knowledge of policy coverage and industry regulations.
- Negotiated favourable settlements for clients, maintaining a high success rate in claim resolutions.
- Maintained strong relationships with clients, fostering trust and loyalty through excellent communication skills.
Econd in Charge - Fixed Line & Broadband Business
Vodafone New Zealand
01.2011 - 05.2013
- Led front-line teams in the absence of team leaders.
- Managed billing, collections, and customer service inquiries across business accounts.
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness and willingness to help wherever needed.
Mobile Business Customer Services Representative
Vodafone New Zealand
02.2010 - 12.2010
- Delivered high-volume customer support with a focus on first-call resolution.
- Trained new staff and maintained quality service standards.
- Collaborated with team members to ensure seamless communication and consistent service delivery.
- Contributed to process improvements by sharing feedback from customer interactions with management teams.
- Streamlined service processes for quicker response times, leading to improved customer experiences.
- Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns.
Education
Bachelor of Arts - Bilingual Education
University of Auckland
Auckland, NZ01-2010
Skills
- Medical & Domestic Claims Assessment
- Insurance Underwriting & Risk Analysis
- Customer Service & Complaint Resolution
- Quality Assurance & Process Improvement
- Cross-functional Stakeholder Collaboration
- Fluent in Mandarin & English
Education & Certifications
Available upon request (please add if applicable)
Timeline
Medical Claims Assessor
NIB Health Insurance
11.2019 - Current
Quality Assurance Advisor
Vero (Suncorp NZ)
11.2017 - 11.2019
Personal Insurance Underwriter (3-Month Contract)
Vero (Suncorp NZ)
08.2017 - 11.2017
Domestic Claims Consultant
Vero
10.2016 - 02.2017
Sales Support and Underwriter ( ANZ Insurance )
Vero
11.2014 - 08.2017
Escalation Manager / Business Complaints Resolver
Vodafone NZ
01.2014 - 08.2014
Corporate and Government Case Manager (Contract)
Vodafone New Zealand
05.2013 - 08.2013
Econd in Charge - Fixed Line & Broadband Business
Vodafone New Zealand
01.2011 - 05.2013
Mobile Business Customer Services Representative
Vodafone New Zealand
02.2010 - 12.2010
Bachelor of Arts - Bilingual Education
University of Auckland
Similar Profiles
Tina NogasTina Nogas
Team Leader Emergency Assistance at nib Health InsuranceTeam Leader Emergency Assistance at nib Health Insurance
Sue BarrettSue Barrett
Customer Care Consultant at nib Health Insurance NZCustomer Care Consultant at nib Health Insurance NZ
Boomita Bullyraz Gungah (Ashweena)Boomita Bullyraz Gungah (Ashweena)
Software Delivery Manager at nib Health Funds LTDSoftware Delivery Manager at nib Health Funds LTD
Maria MarkovichMaria Markovich
Physiotherapist Ellerslie Clinic & Hybrid Role at TBI HealthPhysiotherapist Ellerslie Clinic & Hybrid Role at TBI Health
Adela MusicAdela Music
Casual Sales Assistant at Lush | Auckland Queen StreetCasual Sales Assistant at Lush | Auckland Queen Street