The document provides details of the applicant's employment history and qualifications. It includes 3 past roles: 1) A current role as a Pre-Payment Auditor reviewing medical files to assess claims. 2) Previous experience as a General Scope Nurse in Qatar, managing clinics and patient care. 3) Prior work as an OPD Nurse in the Philippines, providing screening and medical advice. The document emphasizes experience in various medical specialties and qualifications like nursing licenses. Personal attributes highlighted include respect, communication skills, and commitment to patient care.

1. EmploymentHistory:
Pre-Payment Auditor (Medical File Review Analyst, April 2015- Present
SEHA-TPA, AMWAL TOWER DOHA QATAR.
Main Responsibility is to conduct medical file review within the pre-payment - audit
process, as an integral part of the general claims adjudication cycle.
Duties:
• Visit the provider upon need, according to the schedule set by the field delegate supervisor.
• Review cases for Medical and dental claims.
• Prepare the Medical file review required documents, occasionally.
• Check the flagged files for the Seha consent form before reviewing the medical files.
• Review the files in the providers’ premises respecting patient confidentiality.
• Collect accurate information needed regarding the flagged cases, filling the Medical-record-checklist
accordingly.
• Scan the medical file documents that are related to the claims to review using the corporate laptop and
scanner.
• In case of electronic medical file, ask the provider representative to provide a soft copy (CD/USB) for
the requested documents.
• Fill the MFR check list for the missing documents, share it with the provider representative after both
parties signature.
• Prepare a detailed report for the concerned LOT and send it to the field delegates’ supervisor.
• Sort all scanned documents according to the “Document Management process”.
• Secure all confidential documents in a sealed envelope.
• Make sure that no documents are left behind or misplaced and that all tools, (laptops, scanners) are
returned to TPA office.
• Delete confidential documents from the laptop when the MFR is finalized and the report is sent to the
supervisor.
• Upon request, Review cases escalated by the complaints department and prepare the medical file
review report for the concerned case.
• Maintain strict confidentiality in all steps of the medical file review process.
Key Skills and Competencies
Respect confidentiality.
Professional at all time.
Respect hierarchy.
Dedication and commitment.
Good communication skills.
Reliabilityin her behavior.
Flexibility& Punctuality.
Decisionmaking andanalyticalabilities.
Keennessforself-development.

2. Boston Medical Care, General Scope Nurse. September 2012-2015
Al Waab, Doha Qatar
Responsible for managing the clinic and overseeing that all treatment rooms are organized and
appointments run smoothly.
Assessing the nursing needs of patients and providing appropriate care/treatment in every specialty
clinic.
Duties:
 Meeting a patient's nursing care needs.
 Utilizing specialist medical and healthcare equipment.
 Taking a patient's blood pressure,temperature,weight, height measure and random
blood sugar.
 Checking and administering meds, injections and intravenous infusions.
 Drawing blood for cosmetic procedure.
 Making sure all equipment is sterilized and ready before procedures and treatments.
 Producing accurate legible records.
 Responding quickly to emergencies.
 Prioritizing a busy workload.
 Assisting Ophthalmologist, Ob-gynecologist, Plastic and General Surgeon during
minor operations.
 Building a relationship with patients.
 Identifying ways to grow and develop the nursing care.
KEYSKILLS AND COMPETENCIES.
Having the drive and determination required to deliver the highest possible standard of care
to patients.
Familiar with computerized patient information systems.
Team leadership skills and able to supervise junior staff.
Keeping abreast of changes in Nursing and also understand current challenges in the
profession.
Willing to learn and be developed within a successfulbusiness model.
Experience of working within a medical center.
Ensuring stock levels of all medicine, vaccinations and clinical equipment are maintained.

3. Our Lady of Mercy General Hospital,OPDNurse, January 1, 2010-January 15, 2012
DRT Highway Pulilan, Bulacan Philippines.
Responsible of taking care of patients in outpatient facilities.
Providing medical screening and advice to patients which and appropriate assessment.
Duties:
 Drawing blood.
 Maintaining IV lines.
 Checking blood pressure and vital signs.
 Administering vaccines.
 Responding quickly to emergencies.
PERSONAL SUMMARY
A focused professional who is committed to safeguarding the medical needs, comfort and
emotional well-being of patients under her care.
A, enthusiastic, hard-working and competent health care professional who possess the
required level of nursing experience needed to deliver high quality, customer focused, and
clinically effective patient care in a modern well equipped clinical setting.
Key qualities include superb communication skills that enable her to develop a good rapport
with the patient their families and friends.
Also possesses excellent observational skills and is knowledgeable in a variety of specialist
and complex field such as:Ophthalmology, Obstetrics and Gynecology, Dermatology and
Plastic Surgery, General Surgery. In all this previous roles, I acted as a positive role model
for other staff.
Having a realpassion for nursing, with a strong desire to provide the highest level of care
and service to patients.
I am currently looking for a suitable position with a responsible employer who will assist in
the development or my career and skills.

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SEHA - TPA
PERSONAL DETAILS
Name: Niah Jane Mendoza-Cruz.
Nationality: Philippines.
D.O.B: 15 March 1986.
Religion: Roman Catholic
Languages:Tagalog (Native Language) – English (Excellent) – Arabic (Weak)
Address: Al-Sadd, Doha Qatar.
Mobile: +974-30525287
ACADEMIC QUALIFICATIONS
Mt. Carmel College, March 2009
Bachelorof Science in Nursing
AREAS OF EXPERTISE
 Medical Procedures.
 Immunization.
 Health & Safety.
 Administering medication.
 Washing & dressing.
 Drawing Blood.
PROFESSIONAL
 Philippine Nursing Licensure Passer.
 Intravenous Therapy Licensed.
 Qatar Prometric Exam Passer.
 Supreme Council of Health Licensed.
PERSONAL SKILLS
 Caring Attitude.
 Focused.
 Attention to Detail.
 Flexible Attitude.
 Determination.
 Confidence.
 Hard Working.
References –Available onRequest

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SEHA - TPA