Experience

Avon HMO

• Nigeria
• Hospitals and Health Care
• 100 - 200 Employee

• PROCESS STREET ADMINISTRATOR

  • May 2022 - Present

  Functions includes:1. Designing workflow runs in line with the teams data needs. 2. Assigning workflow runs to team members. 3. Collating data from process street weekly. 4. Scheduling of tasks ahead for future timeline allocation.

• MEDICAL SERVICE TEAM ADMINISTRATOR

  • Feb 2022 - Present

  Key Roles as a Medical service Administrator includes:-Organizing and sending out list of providers within Hmo's network to stakeholders.-Assigning worflow runs to team members.-Designing and creating new workflow runs.-Pooling reports from process street weekly.-Providing details of providers/hospitals within and outside Avon's network.-Managing the Avon database and updating recent data of the facilities/hospitals.

• CASE MANAGER/PROVIDER MANAGER

  • Feb 2022 - Present

  Functions includes:-Case management of chronic conditions in the hospital.-Onboarding of hospitals.-Quality assurance, accreditation and reaccreditation of hospitals within Avon's network.-Conducting prevention and wellness health talks for clients and stakeholders.-Decisioning pre-authorization codes and denial of medically unnecessary services.-Cost savings and utilization management. -Regular provider visit to foster and strengthen provider/Hmo relationship.-Conducting case note audit.-Physical facility audit.-Identification of defective claims and education the providers on the right claims submission process.-Education on Avon processes and practices.



AXA Mansard

• United States
• Financial Services
• 700 & Above Employee

• FWA(FRAUD WASTE AND ABUSE) Officer

  • Oct 2020 - Feb 2022

  Functions as FWA officer includes:-Physical auditing of facilities.-Making monetary recoveries through utilization management.-Conducting open and close file review.-Detecting fraudulent and wastage practices within the healthcare sphere.-Verification of healthcare utilization from enrollees.

• Claims reviewer

  • Mar 2020 - Oct 2020

  Functions includes:-Vetting medical claims-Rejecting unnecessary medical claims


County hospital, lagos
• Staff Registered Nurse

  • Nov 2017 - Mar 2020