Mohamed Maouan

– Acted as a bilingual Business Analyst (English and French), bridging stakeholders, insurers, and technical teams. Translated business needs into system solutions within Agile/Scrum environments using user stories, backlog grooming, and sprint planning. – Facilitated workshops, gathered requirements, and ensured alignment across business goals, regulatory needs, and IT deliverables. – Served as a trainer and facilitator for the new GISA portal, supporting insurer adoption through documentation, live training, and post-launch support. – Translated the GISA portal from English to French, ensuring clarity and usability for bilingual end-users. – Led transformation initiatives for leading Canadian insurers (Intact, RSA), supporting claims modernization and regulatory compliance. – Modernized the GISA reporting platform, replacing legacy submissions with automated, scalable digital pipelines. – Redesigned workflows for premiums, paid claims, and reserves, aligned with evolving GISA standards. – Delivered validation rules, exception-handling logic, and Power BI dashboards to enhance data accuracy and SLA monitoring. – Conducted gap analysis and BPMN/UML modeling to improve end-to-end insurer data workflows. – Supported the transformation of business rules and workflows in Guidewire ClaimCenter to improve automation and compliance. – Helped map legacy claims processes into ClaimCenter, configuring user roles, approval paths, and decision rules. – Participated in integrating ClaimCenter outputs with GISA pipelines, ensuring full data traceability. – Led UAT coordination, business rule validation, and post-deployment testing to ensure successful rollouts. – Monitored data quality across insurers and supported cleansing efforts to meet reporting standards. – Simplified technical insights into actionable business recommendations to support data-driven decision-making. – Maintained up-to-date knowledge of insurance regulations, system trends, and emerging technologies.

– Worked as a bilingual Auto Claims Adjuster (French and English), managing property and auto claims with empathy, accuracy, and a customer-first approach. – Conducted thorough investigations into auto claims by reviewing police reports, photos, and evidence, and interviewing claimants and witnesses. – Evaluated vehicle damage through reports and inspections to determine accurate repair costs and settlement values. – Negotiated fair settlements with repair shops and stakeholders, ensuring efficiency and policyholder satisfaction. – Maintained clear, compassionate communication with insured clients, explaining coverage and guiding them through the claims process. – Ensured compliance with internal policies and regulatory guidelines while maintaining high documentation standards for each claim. – Identified potentially fraudulent claims and escalated them for investigation. – Collaborated with appraisers, repair facilities, and legal teams to resolve claims in a timely and professional manner. – In parallel, contributed to the migration to Guidewire ClaimCenter by identifying legacy process gaps and sharing functional insights from frontline claims handling. – Provided valuable feedback on UI behavior, claims workflows, and automation logic to improve ClaimCenter configurations. – Participated in UAT testing for migrated business rules and intake processes, especially during RSA post-acquisition transformation. – Helped optimize STP (straight-through processing) by validating system actions related to coverage, reserves, and payment triggers. – Acted as a bridge between operations and project teams to support continuous improvement in claims automation and regulatory alignment.

– Drive achievement of goals by offering tailored insurance advice and solutions that meet client needs. – Ensuring efficient and effective service delivery by consistently meeting quality and productivity objectives. – Ensure seamless client service, manage call-backs, submissions, and mail processing in a timely manner. – Deliver exceptional service, address client inquiries and concerns, and build trust and satisfaction with a focus on client service excellence. – Efficiently handle a range of assigned tasks to support team operations and client needs through task management. – Identify opportunities for client growth by promoting the company's features and benefits during regular portfolio reviews. – Engage clients in discussions about a range of products at every opportunity and provide comprehensive solutions with product expertise. – Foster long-term client relationships by paying attention to detail, providing personalized service, and being committed to client satisfaction.

– Provide outstanding support while addressing all inbound risk inquiries, including fraud and credit risk assessments. – Ensure eligibility and assess pending credit applications based on established credit guidelines during application review. – Fraud Risk Management entails the evaluation and adjudication of applications that are flagged for potential fraud, as well as the validation and verification of applicants to prevent fraudulent activities. – The purpose of Credit Limit Assessment is to evaluate customer requests for credit limit increases by analyzing financial data and supporting documentation. – Aid merchants in completing credit application processes for both point-of-sale and real-time credit applications. – Ensure compliance and quality assurance by adhering to departmental escalation procedures, quality standards, and PCI compliance requirements. – Use the established escalation matrix to report customer feedback and enhance service quality.