Esther Musili

ESTHER MUTHEMBWA MUSILI CAREER OBJECTIVE I am a committed clinician in pursuing a role in helping people maintain good health and quality life. • • • • • • • • • • • • • • • • ACHIEVEMENTS AND ABILITIES Attained Diploma certificate in clinical medical and surgery. Certificate of computer applications. Awarded certificate of participation in national guidelines for diagnosis, treatment and prevention of malaria. Acquired certificate of participation in science congress up to sub-provincial level and certificate of membership in science club. Certificate of participation in music festivals up to provincial level. Certificate of participation in ball games up to district level. Certificate of membership in scouts’ movement and participated in scouts’ activities and offering first aid to fellow students. A student leader, led to achieving various school projects. Ability to remain calm under pressure. Working under minimal or no supervision and determined to finish what I start, completed research project. Self-motivated and working on extra time to make sure patients are attended to. Strong interpersonal and communication skills, able to solve arising issues with my colleagues prompting to conducive working environment. Presenting information clearly and concisely in both verbal and written form. EDUCATION Diploma in clinical medicine and surgery at Meru Medical Training College,-. ST. Monica girls’ secondary school,-, attained a mean grade of B+. Mwea municipality primary school,-, attained 353 marks out of 500. PROFESSIONAL EXPERIENCE MEDICAL ADMINISTRATOR KENYA LIMITED (JULY 2018 –PRESENT) • Processing and approval of patient’s preauthorization by reviewing patient's history and records and assessing pre authorizations to ensure details are captured correctly. • • • • • • • • • • • • • • Assessing whether patient's treatment and prescription correlates with the diagnosis and is in adherence to scheme rules and with reasonable pricing. Approval of member claim code generation. Confirming membership validity and benefits before pre authorization processing. Negotiation of medical fees and costs of services for the patients with the Service Providers. Managing the daily running of the call center related issues by responding to emails, calls and medical related questions and inquiries. Processing of medical claims for payment and identifying fraudulent. Liaising with supervisors, team leaders, managers and third parties to gain information and resolve issues related to medical claims. Liaising with service providers and referring of patients for specialized care/treatment. Receiving emergency calls, assessing the client’s condition, requesting for an ambulance dispatch for evacuation, informing the receiving facility and following up on the case until the client gets handed over. Identifying fraudulent pre authorizations to reduce costs. Providing cover for colleagues in their absence, ensuring that the handling of pre authorizations is kept up to date. Scheme implementation to enable monitoring of scheme success as well as give insight into the challenges and share lessons learnt with other team members. Taking ownership of complex Medical cases, handling them accurately and with personal attention that is required. Keeping up to date knowledge with respect to the Medical information necessary for handling Medical claims • • • • FREEDOM OF LIFE MEDICAL CLINIC (APRIL 2018 JUNE 2018) Comprehensive history taking, recording, performing physical examination, interpreting findings and managing accordingly. Requesting and interpreting relevant laboratory investigations. Prescribing and explaining treatment to patients and their effects. Attending to emergencies and referring appropriately. Conducting minor surgeries and following up till the client fully recovers. • • • • MUKURWEINI SUB-COUNTY HOSPITAL (INTERNSHIP APRIL 2017MARCH 2018) Comprehensive history taking, recording and presentation. Performing clinical examination, interpreting findings and managing accordingly. Requesting and interpreting laboratory and radiological investigations. Prescribing and explaining treatment to patients. • • • • Managing emergency cases and referring appropriately. Managing common pediatric, medical, surgical, obstetric and gynecological conditions. Performing pediatric, surgical, medical, obstetric and gynecological procedures and following up on the clients. Attending patients in pediatric, medical, surgical and gynecological outpatient clinics. Observing and assisting in caesarian sections and performing spontaneous vaginal deliveries. Providing focused antenatal, post-natal clinics and offering immunization as per the kepi schedule. Providing prevention of mother to child transmission of HIV/AIDS services. Advising on family planning methods and offering as per the patient’s preference. Assisting in cervical cancer screening and explaining to clients on the signs and symptoms and its prevention. Attending to patients in comprehensive care clinic, counseling sero reactive patients, issuing antiretroviral drugs and attending to patients in chest clinic Filling medical legal documents. • • INTERESTS Reading. Charity work among vulnerable groups. • • • • • • • • REFEREES Please feel free to contact the under mentioned in regard to my competence ,work ethics, performance and or any other aspect with respect to me. MR. DENNIS OKEMWA Supervisor, Medical Administrator Kenya Limited,-. DR.FRANCIS MUSYOKI Medical physician, Consultant medical department, Mukurweini sub county hospital-.