Cliff Radido Email & Phone Number

Nairobi, Kenya

My Roles Under Medical Claims Analyst :+Risk Supervision – Overall process management to shield the company from any potential liability emanating from claims processing+Ensuring complete and sound claim settlements, legal reviews and investigations in accordance with company policies and procedures+Claims Review and Approval – Review claims processed to ensure that all claims fall within scope of respective medical insurance policy and comply with claims management policies and procedures.+Business Advisory – Monitor and review claims trends and provide necessary advisory to the business for decision-making, innovation, and strategy review.+Investigating potentially fraudulent claims+Liaising with colleagues to identify improvements in claims procedures+Maintaining current knowledge with regard to industry compliance and claims regulation

+Define project requirements by identifying project milestones, phases and elements.+Develop user stories and to-be process flows to support the design and development of solutions for our clients. +Create and maintain a channel of communication between stakeholders and IT teams during development and implementation.+Work with stakeholders and IT teams to develop a report based on business requirements+Collaborate with developers to test and verify that solutions will meet the business requirements