Heaven Wagih
Suez,Egypt
Summary
Experienced Claims professional with over 6 years in international medical insurance. A passionate challenging leader focused on change, progress, and coaching teams to deliver consistent performance and customer‑centric results.
Overview
7
7
years of professional experience
5
5
years of post-secondary education
Work history
BEI Quality assurance Specialist
BEI
Cairo , Egypt
2026.04 - Current
- Handling 40% QA Managerial tasks & 60% on QC functions.
- Responsible for the Time and motion across BEI and UAE to work on QA resources VS Framework objective.
- Recruiting new QCs for BG & UKI teams through interviews & technical assessments.
- Data analysis using SWAN Adhoc reports, CSMI and PBI.
- Providing monthly 121 sessions & observations.
- Planning the Monthly objective for BEI & UAE teams and tracking the annual leaves requests.
- Reviewing the scorecards to cope with the observations and trends.
- Assigning and extracting the monthly targeted checks to the team.
- Preparing the senior packs for global trends and errors.
- Handling different stakeholders through the appeals and discussions & agreeing on action plans.
- Representing the QA management in monthly trends analysis sessions with BEI and UAE across different functions including: CRT, MR, UW, BP, Membership, Claims and customer service.
- Handling conflicts and feedbacks internally and externally.
Quality Assurance Consultant
BEI
Cairo , Egypt
2021.02 - 2026.03
- Led audits across multiple global claims teams such as : Claims teams -Claims management -High value -High Risk -Centre of excellence- Providers Services - claims info provided in different regions including Egypt, BES, UAE and Genpact.
- Ensuring delivering Elite service to our customers with fair standards and quality level to exceed 95% through the daily audits and feedback.
- Delivered constructive feedback, 100% live audits to all the assessors and coaching notes to the frontline and providing trainings & workshops to address the root cause analysis.
- Demonstrated consistent delivery of customer-focused outcomes within regulatory QA environment, maintaining full competency across all required functions.
- Supported in internal QA recruitment, sign off within 3 months , levelling sessions for new QCs (almost 20 QCs).
- Responsible of QA monthly meetings including monthly QA reviews, trend analysis, live audits, levelling sessions.
- Working as a delegate to support in reviewing appeals, working on observations for the other claims QA, monthly tailored planning objectives, preparing reporting packs, tracking targeted checks, providing training and motivational topics for QA and maintaining updated documentation.
- Participated in C&G activities: QA News letter, fun committee, NPS engagement group, career focus group and First Aid.
- Upskilling in Customer service, medical risk, Counter fraud and membership teams.
Claims info assessor
BES
Cairo , Egypt
2019.10 - 2021.01
- Ensured accurate policy and coding application for Bupa International claims within SLA.
- Proactively addressed potential fraud & recording the savings.
- Communication with the customers, providers, service partners by calls to accelerate the MI process.
- Delivered consistent excellent customer service aligned with company goals and positive feedbacks from the customers.
- Supported planning and inventory tasks as a delegate.
- Coaching new joiners & delivering feedback to CS teams.
Education
Bachelor of Pharmacy and biotechnology - Pharmacy
The German University in Cairo
Cairo / Berlin 2014.09 - 2019.06
Skills
Analytical decision making
Compliance risk management
Ethical standards adherence
Strategic planning
Data analysis using Adhoc reports, PBI and CSMI
Clear and constructive feedback
Rapport building capability
Team bonding activities coordination
Flexibility improvement
Customer oriented approach
Driving business improvement
Coaching and training
Projects with Bupa
- Vulnerable customer Forum with Carla Blackman.
- NPS workshop analysis with BEI operations.
- NPS & Q-track analysis with Genpact operations and Chris Hand.
- Genpact support lead with Chris Hand.
- BEI Policy Review with Diana Fahmy.
- C&G Engagement group.
Timeline
BEI Quality assurance Specialist
BEI
2026.04 - Current
Quality Assurance Consultant
BEI
2021.02 - 2026.03
Claims info assessor
BES
2019.10 - 2021.01
Bachelor of Pharmacy and biotechnology - Pharmacy
The German University in Cairo
2014.09 - 2019.06