Shashikala Shrestha Pradhan
Clinical Case Manager at CIGNA LIFE INSURANCE COMPANY OF EUROPE SA NV SUCURSAL EN ESPAÑA- Claim this Profile
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Bio
Experience
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CIGNA LIFE INSURANCE COMPANY OF EUROPE SA NV SUCURSAL EN ESPAÑA
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Spain
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Insurance
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1 - 100 Employee
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Clinical Case Manager
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Jun 2019 - Present
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Cigna Healthcare
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Hospitals and Health Care
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700 & Above Employee
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Medical Claims Analyst
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Nov 2017 - May 2019
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Medical Claims Manager
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Dec 2016 - Oct 2017
• Responsible for providing leadership, training, guidance and support to the medical claims and approval teams. • Monitor the claims functions to maintain the target loss ratios. • Coordinate with the General Manager regarding general claims policy, procedures and system. • Identify and initiate training needs for the claims and approval teams. • Work with the Operations Manager with regards to loss experience of various clients and suggest ways for improvement, imposition of better control etc. • Work with the Network team for developing and maintaining a service provider network conducive to serve clients and match competitors. • Attend meetings with medical professionals, service providers, hospitals and clinics and ensure well-coordinated service relations at all times. • Assist Underwriting team with new quotes and business. Show less
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Al Khazna Insurance Company
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Dubai, United Arab Emirates
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Senior Claims Adjudicator (Team Leader)
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Oct 2013 - Nov 2016
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Al Sagr National Insurance Company (ASNIC)
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United Arab Emirates
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Insurance
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200 - 300 Employee
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Managed Care Executive
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Oct 2011 - Sep 2013
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Education
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Guangxi Medical University
Bachelor of Medicine, Bachelor of Surgery - MBBS, Medicine