Edmar Jose Santos
Mobile Number: -
Email Address:-
Profile:
Highly experienced Insurance Specialist with over nine years of expertise in adm inistrative operations, claim s
assessment, business quality evaluations, and quality control. Proven ability to im plement and oversee new com pany
procedures while m aintaining exceptional customer service standards. Proficient in Microsoft Office, CRM, Ingenium ,
and the Life Asia system, with a strong com m itm ent to exceeding both personal and team goals to drive com pany
success and surpass client expectations.
SKILLS:
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Early adopter to changes in
line of business
Operational Strategies
Decision Making
Claim s Assessment Insurance
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Perform ance Assessment
Team Leadership
Tim e Managem ent
Ability to Multitask
Data Entry
Virtual Assistant
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Custom er Relationship
Building
Regulatory requirements
Understanding
Quality Assurance (QA)
Adm inistrative Task
EXPERIENCE:
Apr 2023 – Present
Position: Customer Success Engineer (New Business & Claims)
Company: Pru Lif e UK
Location: BGC Taguig City Philippines.
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Feb 2019 – Apr 2023
Create paym ent request (CPR) endorsed by Claim s Assessors, and submit to
QA team for assessm ent of the paym ent and docum ents.
Quality assurance of CRM system and subm itted docum ents of the client.
Gather analyses and records claim s data.
Data encoding to CRM system
Tracking and logging of all rejected m anual and auto claim s from finance.
Creating and letter for clients notice via em ail.
Coordinate with claim s assessors and m anagers regarding legal docum ents.
Evaluation of claim s (dialysis, Cause of death claim or living claim .
Collaboration with finance team to ensure that those submitted claim s
paym ents are not duplicate .
Position: Quality Control Specialist
Company: Pru Lif e UK
Location: BGC Taguig City Philippines.
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Responsible for evaluating and docum enting quality reviews to ensure New
Business Life Operations team comply with the procedures and regulations of
the organization, m eet team targets, and custom er service standards.
Investigate quality concerns or m issing requirem ents of new policy
applications and recommends correction, corrective or preventive solutions to
Underwriting team or Financial Advisor.
Identify opportunities for a process im provem ent, and coordinate with
different business units to assist in im plementation of solutions in line with
key business objectives.
Ensuring that standard and quality of insurance documents and processes are
observed.
Determ ine the causes of new system innovation defects and reworks.
MAR 2018 – SEP 2018
Position: New Business
Company: FWD Lif e Insurance
Location: BGC Taguig City Philippines.
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AUG 2017 – JAN 2018
Position: Transf ormation Project Assistant (Contractual)
Company: AIA Philippines
Location: BGC Taguig City Philippines.
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JUL 2015 – JUL 2016
Obtains and verifies client inform ation via call-outs to ensure accuracy of
policy details in the database
Determ ines by comparing client’s information to requirements like ID,
Signature, Application form s.
Maintains and im proves quality results of the policy contract’s delivery process
Monitors delivery reports with the com pany’s courier
Assists New Business compliance team every m onth-end to upload all client’s
application requirem ents in the system
Assists New Business QA team every m onth-end to review and evaluate all
client’s details and application requirements to ensure that they conform to
the quality standards set by the com pany
Perform s disposition call outs to clients to secure the delivery of the policy
contract for return to the com pany
Manages Return-To-Sender (RTS) policy release
Requests ‘close-out’ documentation requirements from ‘Contractor’ 5such as
business permit, occupancy permit, approved built plan, m anuals, test form
contracts.
Monitors FOT Project Tracker & Action Item s
Monitors IT assets such Chrome cast, Laptops, Projector, Apple Ipad for
deploym ent to different sites
Assists Facilities department for deployment and installment of items needed
for the projects
Handles projects
Creates requests in ARIBA system for catalogs item s and payables to vendors
Creates Request for Purchase (RFP) of
Responsible for sending out items like speakers, furniture, Gadgets, to
different com pany branches
Position: Policy and Plan Change Associate 2
Company: Sun Lif e Philippines
Location: BGC Taguig City Philippines.
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Prepares stale checks and outstanding disbursem ent reports
Monitors cash requests for finance team ’s check preparation
Monitors policy contracts for reinstatem ent and distribution
Prepares on-line transmittal to m ailing section and locate where they sent all
the transactions
Forwards OS, reinstatem ent files to records m anagem ent team
Processes change requests of beneficiary details in the client’s account and
ensures its accuracy
Processes reinstatement reports and coordinates with the clients/financial
advisors to know the details and m edical condition of the client before
processing the client’s account
Coordinates with clients via phone calls and em ails to address their concerns
about their policy reinstatem ent and beneficiary change requests
Refers reinstatement requests to underwriting team as necessary; Advises
clients about the m edical requirem ents for their policy reinstatem ent
Prepares reinstatem ent and stale check in prism system
Monitors client’s status in the Ingenium system
Updates client’s profile in the Sun Life’s work system
Analyses and com putes the PDI and SRO in reinstatem ent policies
JUN 2014 – FEB 2015
Position: Underwriting
Company: Pacif ic Union Insurance Company
Location: BGC Taguig City Philippines.
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Calculates prem ium s refunds, com m issions, adjustm ents of policies.
Adds new reserve requirem ents using insurance rate standards.
Checks communication of accrued interest, premium due, and settlement
surrender on loan values.
Coordinates with agent or m arketing m anager to inform them of underwriting
actions. m ade in the new policy applications.
Maintains related files.
Maintains and files accounting records by m aking copies.
Maintains accounting database by encoding data.
Handles purchase of supplies and equipment as authorized and requested by
the m anagem ent.
Monitors office supplies and processes its replenishm ent.
Records cash receipts and m akes bank deposits.
Maintains the petty cash fund of the team .
Provides clerical and adm inistrative support to m anagem ent as necessary.
EDUCATION :
University: Centro Escolar University
Degree: Bachelor of Science in Business
Administration Major in Management.
Graduated: 2010 - 2014
CERTIFICATES AND COMPLETIONS:
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LOMA 281 Meeting Custom er Needs with Insurance and Annuities -3rd Edition - Novem ber 2024.
Custom er Obsession Skill at Work Training Series - July 2024.
Data Governance Fundam entals - June 22.
Design Thinking: Understanding the Process - August 2021
System Thinking Fundam entals - March 2022
LANGUAGES
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Tagalog
English
Interest
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Playing Guitar (Both Acoustic & Electric)
Badm inton
Watching Neflix (Anim e, Rom ance, Thriller)
Drawing
Travelling
Basketball
Video Gam e
Music (Opm rock)
