Mark Kandie

Pro

Claims Assessor at MUA Insuarnce

since July, 2021

ma***18@gmail.com

Work experience

Receiving and accurately capturing of medical claims into the medical system (HAIS)
Verifying the benefits and authenticity of membership in accordance with the benefits templet
Handling of coverage simple enquiries with brokers, providers, members etc.
Verifying the validity of the service provided by the service provider in relation to the benefits covered,
treatment given, adherence to provider panel rules and cost of treatment
Obtaining additional required information on claims from providers, brokers, or clients
Preparing for the return of claims with inadequate documentation or claims that members are not insured
for after having been confirmed with underwriters.
Liaising with our underwriting section on scope of cover for various schemes
Advising the approver on any peculiarities noted in the claims from group providers

Work experience

Managed the registration of claims into the medical system
Assessed the requirements of the claim against the terms and conditions of the relevant policy, answering
queries in relation to clinical treatment or pre-authorization requests.
Received calls from clients, providers, and members in relation to new or ongoing claims, providing the
highest standards of customer service.
Obtained medical evidence from providers to substantiate claims decisions.
Liaised with the medical team to arrange care and monitoring treatment plans for members.
Ensured all information is accurately updated in a timely manner, actions are carried out diligently and all
parties are informed of relevant information.
Developed and maintained a strong understanding of insurance policies and legal issues
Responded to all relevant incoming correspondence and queries from the company’s internal departments

Work experience

Managed the sorting, verification and dispatch of orders from various customers.
Produced invoices from customers' lists of purchasing orders.
System stocks transfers.
Issued books donations to government leaders and Various academic institutions and kept records of the
same.
Periodically involved in printing and packaging materials for different institutions.

Work experience

Maintained up to date record through filing and database management.
Negotiated with suppliers at branch level and made follow up for their payments.
Responded to customer instructions through RTGs, EFT through my supervisor.
Scheduled branch meetings and ensured all the necessary resources were made available.
Answered correspondence for both internal and external customers.