# Tilus Chege Tilus Chege is a remote worker on Himalayas, Medical Case Manager at Medical Administrators of Kenya Limited, based in Kenya. Source: https://himalayas.app/@tiluschege ```text Medical Case Manager at Medical Administrators of Kenya Limited who reviewed clinical documents and supported claims and pre-authorisation. ``` | Detail | Value | | --- | --- | | Availability | Looking for a job | | Location | Kenya | | Authorized to work in | Kenya | | Salary expectations | 65k+ USD | | Job categories | Medical Case Manager, Claims Assessor, Health Insurance Administration, Clinical Operations Specialist, Healthcare Quality Specialist | | Skills | Medical Case Management, Claims Assessment, Claims Documentation Review, Prior Authorizations, Healthcare Benefits Administration, Medical Report Review, Claims Verification, Patient Care Coordination, Admission And Discharge Coordination, Patient Provider Communication, Medical Records Management, Clinical Documentation, Clinical Assessment, Diagnosis and Treatment Planning, Patient Follow Up | | LinkedIn | https://linkedin.com/in/tilus-qariuqi-53aa18104 | ## What I'm looking for ```text I’m interested in opportunities in medical case management, claims assessment, health insurance administration, clinical operations, and healthcare quality. ``` ## About ```text At Medical Administrators of Kenya Limited, I followed up on medical cases and reviewed supporting documents for public-sector, corporate, and institutional medical schemes, including those for the National Police Service and the Teachers Service Commission. I supported pre-authorisation and claims assessment by checking clinical information and documentation, following up on outstanding records, and referring cases for further review when needed. At Bliss/Nairobi West Hospital and Naivasha District Hospital, I assessed patients, developed initial diagnoses and treatment plans, and monitored progress for medical and surgical conditions. My clinical background helps me understand medical reports and treatment requirements. I’m interested in medical case management, claims assessment, health insurance administration, clinical operations, and healthcare quality. ``` ## Experience ### Medical Case Manager Medical Administrators of Kenya Limited. Jan 2021 - Dec 2024 ```text Followed up on medical cases, reviewed medical reports and claims documents, and supported pre-authorisation and claims assessment processes. Communicated with healthcare providers to resolve case-related issues and maintained confidential case records. ``` Skills: Medical-Case-Management, Claims-Assessment, Prior-Authorizations, Healthcare-Benefits-Administration, Patient-Provider-Communication, Patient-Care-Coordination, Medical-Records, Microsoft-Word, Excel, Hospital-Management-Systems, Electronic-Medical-Records ### Medical Officer Bliss/Nairobi West Hospital. Jan 2017 - Dec 2020 ```text Provided clinical care to patients with medical and surgical conditions, including patient assessment, diagnosis, treatment planning, and monitoring. Maintained accurate medical records and coordinated patient management with healthcare professionals. ``` Skills: patient-assessment, Clinical-Assessment, Diagnosis, Treatment-Planning, Laboratory-Tests, Patient-Monitoring, Medical-Records, Patient-Education, Care-Coordination, Confidentiality ### Medical Officer Naivasha District Hospital. Jan 2016 - Dec 2017 ```text Provided clinical services to patients with a range of medical and surgical conditions, including patient assessment, diagnosis, treatment, and documentation. Coordinated with other healthcare professionals to support patient care. ``` Skills: patient-assessment, Clinical-Assessment, Diagnosis, Treatment-Planning, Investigation, Patient-Monitoring, Referrals, Medical-Records, Care-Coordination, Confidentiality ## Education ### University of Nairobi Degree in Medicine and Surgery, Medicine and Surgery ```text Completed a degree in Medicine and Surgery from the University of Nairobi in 2016. ``` ## Tech stack - Microsoft Excel - Microsoft Word To contact Tilus, message them from this profile with a Himalayas employer account: [Hire on Himalayas](https://himalayas.app/hire). ## People also viewed - [Sheila Mbogo](https://himalayas.app/@sheilambogo): Medical Claims Assessor, AAR Insurance Kenya - [Rahab Gikami](https://himalayas.app/@rahabgikami): Revenue Assurance Manager, Valley Hospital - [Margaret Maina](https://himalayas.app/@margaretmaina3): Care Manager, Jubilee Health Insurance - [Phanice Miranyi](https://himalayas.app/@phanicemiranyi): Clinical Services Manager, Meridian Equator Hospital - [Rachel Onyonyi](https://himalayas.app/@rachelonyonyi): Clinical Officer, Ladopharma Medical Centre - [wanda makena](https://himalayas.app/@wandamakena): Case Manager, Minet Kenya Insurance Brokers - [Michael Ochara](https://himalayas.app/@michaelochara): Care Manager / Medical Claims Analyst, Medical Administrator Kenya Ltd - [GEORGE NG'ANG'A](https://himalayas.app/@georgenganga2): Clinical Officer, ACK Mount Kenya Hospital - [Fridah Kaburu](https://himalayas.app/@fridahkaburu): Supervisor Medical Claims, Zamara Risk & Insurance Brokers - [jesse User](https://himalayas.app/@jesseuser7): Head of Medical Claims, Radiant Group of Hospitals