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مهارتها
تجربه
Assistant Mint Product Administrator / Case Manager
Kenbright Insurance Brokers
2025-04 - ui.present
Responsible for end‑to‑end claims processing, verifying eligibility, and ensuring timely settlement while adhering to scheme rules. Manages member registration, updates databases, and handles newborn, spouse and termination entries. Acts as primary liaison with hospitals, handling pre‑authorizations, medical reports, and 24‑hour emergency line coordination. Leads call‑center operations, resolves member queries, and escalates complex issues to the Scheme Administrator. Produces weekly and monthly claims, utilization and membership reports, and supports policy renewals and performance reporting. Provides compliance and audit support, ensuring alignment with IRA regulations and SHA requirements.
Medical Analyst / Care Manager
Medical Administrator Kenya Limited (MAKL)
2019-10 - 2025-04
Coordinated integration of care‑management functions into patient pathways and conducted concurrent medical record reviews using defined indicators. Investigated and reported adverse occurrences related to client management and policy compliance. Facilitated communication between clinical teams and insurers, ensuring accurate documentation and timely interventions. Supported data‑driven decision‑making through analysis of claims trends and utilization patterns. Contributed to continuous improvement initiatives aimed at enhancing member experience and operational efficiency.
زبانها
English
fluent
آخرین بهروزرسانی: 2 ماه پیش