Niko De Lima

One of the leading Third Party Administration (TPA) company in the
region that caters big insurance companies and serving thousands
of members in the whole Arab Emirates. Main functions as follows:
• Gathers and process all the information needed to complete the medical insurance claims.
• Taking inbound costumer service calls and making outbound calls to the patients and healthcare providers.
• Analyzing all information gathered before giving approvals or rejections accordingly on every claims with prior consultation to the pre-approval manager.
• Monitoring the limits of each member’s before giving approval for a particular claims.
• Refers questionable claims to the manager, investigating pending claims and resolve discrepancies.

A well recognized treatment rehabilitation facility in the Phils. for substance abused and clients with attitude disorders. Main functions as follows:
• Gathers all pertinent information, medical history, medication and diet plan of the patient during the turn over phase of the family members or the hospital.
• Taking the routine vital signs, giving medication everyday and implementing proper activities of daily living as prescribed.
• Assisting the facility physicians or psychiatrist during their visits in the facility and carrying out their orders accordingly.
• Reporting to the immediate superior urgently if untoward incident happens.

A premier tertiary level IV hospital in Southern Phils. with 100 +
bed capacity that provide wide range of treatment in the
different specialization of medicine. Main function as follows:
• Doing the nursing process to every patient during the nursing rounds or admission.
• Taking the routine vital signs, giving medication everyday and implementing proper activities of daily living as prescribed.
• Assisting the attending physicians during their rounds and carrying out their orders accordingly.
• Attending urgently on every code blue and reporting to the immediate superior urgently if untoward incident happens.