Ibrahim Barasa

Dedicated and results-driven Clinical Medicine Officer with over six years of progressive experience in healthcare insurance, claims management, and patient care. Proven expertise in pre-authorization audits, claims reconciliation, cost containment, and contact centre operations within the insurance sector. Adept at building relationships with service providers and clients while ensuring compliance with organizational standards and achieving set targets.

Medical Care Manager – Call Centre - First Assurance Company Ltd

(2024-04)

• Manage inbound and outbound calls in line with contact centre guidelines, providing professional solutions within stipulated turnaround times.
• Critically analyze and issue approvals for both outpatient (OP) and inpatient (IP) cases.
• Escalate complaints and feedback received via calls to respective departments or the line manager for resolution.
• Advise prospective and existing customers on medical products, services, and member benefits.
• Negotiate costs with service providers to achieve sustainable cost containment.
• Conduct outbound follow-up calls for post-hospitalized members.
• Handle additional official tasks as assigned by the line manager.

Care Manager / Claims Analyst - Medical Administrators Kenya Limited (MAKL)

(2019-04 - 2024-04)

• Monitored patient progress and responded to pending issues from service providers in a timely manner.
• Vetted and processed reimbursement claims ensuring accuracy and compliance.
• Coordinated and processed company responses to claims and pre-authorization requests.
• Followed up with providers on outstanding bills, billing discrepancies, and information required to expedite processing.
• Responded to client enquiries on claims via email, telephone, and in-person interactions.
• Resolved disputes related to claims and pre-authorization by liaising with medical service providers.
• Maintained and monitored inventory records, ensuring targets and turnaround times were consistently met.
• Supervised distribution of educational material to patients in collaboration with clinical officers.

Registered Clinical Officer (RCO) - Bliss Healthcare

(2019)

• Diagnosed and treated a wide range of medical conditions, providing comprehensive patient care.
• Ordered and interpreted medical tests and investigations.
• Performed routine medical and surgical procedures.
• Referred patients for specialist management where clinically indicated.
• Collaborated with multidisciplinary teams to ensure quality healthcare delivery.
• Submitted NHIF claims in compliance with scheme guidelines.

Diploma - Clinical Medicine, Surgery & Community Health - Kisii University (2013 - 2016)

Kenya Certificate of Secondary Education (KCSE) - Kakamega High School (2008 - 2011)