Dancan Karakach
@dancankarakach
Experienced Senior Medical Claims Analyst with a focus on fraud prevention.
KenyaWhat I'm looking for
I am a dedicated Senior Medical Claims Analyst with extensive experience in the insurance industry, currently working at Cigna International Health Benefit. My role involves reviewing claims to identify areas for improvement, implementing fraud detection methods, and providing expert guidance to resolve complex claims issues. I take pride in being a primary point of contact for partners regarding claims-related inquiries, ensuring that customer service is at the forefront of my responsibilities.
Previously, I worked as a Reinsurance Officer and Underwriting Assistant at Pioneer Assurance, where I honed my skills in preparing reinsurance treaty payments, negotiating treaties, and conducting financial underwriting. My educational background includes a Bachelor of Science in Actuarial Science, complemented by certifications in Data Analytics. I am passionate about leveraging my analytical skills to drive organizational success while continuously seeking opportunities for professional growth.
Experience
Work history, roles, and key accomplishments
Senior Medical Claims Analyst
Cigna International Health Benefit
Jan 2022 - Present (3 years 4 months)
Reviewed sample claims to identify areas for improvement and implemented methods for blacklisting persons & providers involved in insurance claims fraud. Served as a primary point of contact for partners regarding claims-related inquiries, providing expert guidance and support to resolve complex claims issues.
Reinsurance Officer
Pioneer Assurance
Jul 2021 - Dec 2022 (1 year 5 months)
Prepared reinsurance treaty payments and renewals, and created claims reinsurance reports on premiums and claims for management reporting. Collected recoveries from other reinsurance companies and submitted treaty and facultative claims for recovery.
Underwriting Assistant
Pioneer Assurance
Jan 2020 - Jun 2021 (1 year 5 months)
Ensured accurate reinsurance underwriting and allocated risks to appropriate treaties and other RI arrangements. Assessed proposals and accompanying schedules to ensure all requirements were met and communicated any shortfalls.
Claims Assistant
Pioneer Assurance
Jun 2019 - Dec 2019 (6 months)
Entered claims into the system for analysis and vetted and analyzed claims documentation. Processed and paid claims, and assisted in customer service for walk-in clients.
Branch Administrator
Pioneer Assurance
Jan 2019 - May 2019 (4 months)
Performed data entry for new business acquired and attended to walk-in clients' inquiries and complaints. Prepared and submitted financial reports for the branch.
Education
Degrees, certifications, and relevant coursework
Jaramogi Oginga Odinga University
Bachelor of Science, Actuarial Science with Information Technology
Studied Actuarial Science focusing on the application of mathematical and statistical methods to assess risk in insurance, finance, and other industries. Incorporated Information Technology principles into the curriculum.
Zachtech Training College
Program, Data Analytics
Grade: Distinction
Completed a program focused on Data Analytics. Gained proficiency in using tools like Excel and SPSS for data analysis.
St. Jacobs Kaliwa Secondary School
KCSE, Secondary Education
Grade: A-(75)
Completed secondary education. Achieved a grade of A- (75) in the Kenya Certificate of Secondary Education (KCSE).
Tech stack
Software and tools used professionally
Availability
Location
KenyaAuthorized to work in
Job categories
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