Job Summary

The role is responsible for the application of medical expertise in Medical insurance claims processing

  • Minimum Qualification: Diploma
  • Experience Level: Mid level
  • Experience Length: 2 years

Job Description

Reporting Supervisor:   MEDICAL TEAM LEADER



Core Responsibilities

  1. Clinical officer has to be well equipped with the latest trends and technologies used.
  2. Expert in analyzing actual and fake treatments claims.
  3. Expert in drafting the process in and out.
  4. Smart in tackling various types of clients.
  5. Clinical officer has to be the one and only stop for whole process execution for clients.
  6. Clinical officer is incumbent for the billing, filing, updating and processing of medical claims related to patient diagnoses, treatments and medications.
  7. Process Company’s response to claims.
  8. Regular liaison with insurers, loss adjusters/appointed experts.
  9. Utilizing new Claims repository.
  10. Perform data entry and processing.
  11. Formulate objectives and processes.
  12. Monitoring inventory records.
  13. Supervising the educational material provided to patients by clinical officer.
  14. Evaluating the Preparation and delivery of claims presentations by clinical officer.
  15. Provide cover for colleagues in their absence, ensuring that the handling of their claims is kept up to date.Liaising with other healthcare personnel for efficient delivery of patient care.
  16. Treating or referring them to respective specialists.
  17. Responding to mails, calls, and medical related queries on social media platform.
  18. Any other duties as may be assigned.


JOB REQUIREMENTS   -        100%

Minimum Qualifications 

  • Diploma clinical medicine and surgery/community health. 
  • Registered and licensed by the relevant medical body. 
  • Experience 2 years and above experience in relevant medical field & Hospital Administration  

Technical/Behavioural Skills

  • Computer literacy
  • Decision making
  • Ability to learn
  • Morally upright
  • Clear communication
  • Empathy
  • Attentive listening
  • Positive attitude
  • Willingness to go the extra mile
  • Knowledge about products and services


Language Skills

  • English (Preferred)Swahili

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