

Dedicated and compassionate healthcare professional with a strong foundation in nursing practice and a growing expertise within the Health Management Organization (HMO) sector. Currently serving as a Closed File Review Officer at AXA Mansard Health Insurance, applying clinical background to ensure accurate medical claims auditing, quality assurance, and regulatory compliance. I bring extensive hands-on experience spanning emergency care, inpatient and outpatient monitoring, medication administration, antenatal services, immunization, community health, and home-based patient support. My years as a Staff Nurse, Community Health Extension Worker, Community Health Volunteer, and Professional Home Carer have equipped me with exceptional assessment skills, critical decision‑making ability, and a deep understanding of patient care pathways. I am highly skilled in interpreting clinical documentation, evaluating treatment appropriateness, performing care checks, and collaborating with healthcare providers to promote efficient, safe, and patient‑centric service delivery. Committed to improving healthcare outcomes both clinically and administratively, I strive to support the delivery of high‑quality health services within the HMO system.
Support teams in conducting care checks and comprehensive closed-file reviews to ensure accuracy and compliance.
Assist in auditing medical claims treatment plans and submitted documents to identify discrepancies and prevent fraud.
Evaluate medical necessity and treatment appropriateness according to AXA Mansard clinical guidelines.
Review provider documentation for completeness and adherence to regulatory compliance.
Prepare audit reports that highlighted error trends and areas needing corrective action.
Collaborate with healthcare providers and internal teams to address identified issues.
Suggest process improvements to enhance quality assurance and minimise claim errors.
Saving life, Socializing, Drumming, Dancing, Singing, Reading
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