Edwin Wekesa

I am an experienced insurance professional specializing in health underwriting and claims management. I have a solid understanding of medical risk assessment, policy evaluation, benefits set-up and portfolio management.

I have extensive knowledge and experience in managing policy onboarding and endorsements, member additions and deletions, reviewing medical questionnaires and enhancing compliance with insurance regulatory standards. My understanding of underwriting principles, policy wording, exclusions, waiting periods, benefit limits, and other regulatory requirements further enhances my underwriting capabilities.

In claims management, I have hands-on experience in end-to-end claims processing including claims notification, verification, vetting, cost containment, fraud detection and timely settlement. I demonstrate excellent analytical skills that is necessary in reviewing medical applications, medical reports, invoices, and provider documentation to ensure accuracy and reduce leakage in health insurance operations. Besides, I am conversant with multiple Insurance Information Management Systems and CRM tools that enhances operational efficiency and Turn Around Times.