Alonge Glory

Experience

• 

  Hygeia HMO

  Sept 2007 - Oct 2019

  • Data Analyst

    Jan 2015 - Oct 2019

  • Administrative Executive

    Sept 2007 - Dec 2014
• 

  MetroHealth Hmo

  Dec 2017 - now

  Medical Claims Executive

  Medical Claims ExecutiveResponsibilities; Claims Inventory: receiving, printing and updating received claims from providers Vetting of claims Computation of vetted claims. Provision of detailed breakdown of claim payments to providers. Documentation of providers’ payments and evidences of payment. Training and re-training of new and existing team members on the new developments in the operational services expectation. Identifying process bottlenecks and developing opportunities to automate function and improve process policies. Direct supervision and evaluation of team’s daily routine activities and performances. Other duties as assigned by head of medical. Show less

• 

  MetroHealth HMO Ltd

  Oct 2019 - now

  Underwriter

  Prepares business report for clients as renewals approach/fall due, prompting client service managers to follow up premium paymentReview of membership forms for new clients and additions, ensuring they conform to MetroHealth underwriting guidelines before on-boarding such members to the network.Entry of encounter data from providers with the goal of building up big data for more quality data analysis and predictive modelling.Prepare and deliver professional presentations and participate in new case implementation meetings.Prepare and document presentations for utilization report for various clients.Pull and analyze claims and capitated encounter data to develop utilization report for renewing clients, using certain criteria essential for the underwriting of risks of their varying health plans.Underwriting renewals of existing businessesPrepare business report for new client to ascertain profitability Show less