- Pre-authorise scheduled and non-scheduled admissions within the set guidelines
- Liaise with the hospitals and doctors for prompt submission of the admission summary form.
- Monitor procedures being carried out on patients and see to the general well being of the patient.
- Assess and authenticate inpatient and outpatient medical claim documents.
- Revise reserves after discharge of a member.
- Ensure smooth discharge process and coordinate any necessary post-hospitalization care.
- Visit health care Institutions in the assigned region to confirm admissions.
- Prompt collection of claims paid out of policy liability
- Process reimbursements within the stipulated time.
- Assist in carry out verification and medical audit of claims invoices before settlement.
Knowledge, experience and qualifications required
- Diploma in Nursing
- Basic understanding of insurance concepts
- 1-2 years’ experience in case and claims management
- Registered Nurse with Nursing Council of Kenya
- Knowledge of case management processes and procedures
- Knowledge of insurance regulatory requirements and concepts
- Proficient in use of Microsoft office suites and packages
Interested candidates should attach the following when submitting their applications:
- Curriculum Vitae
- Two recommendation letters from persons familiar with applicants’ work
- Copies of relevant Academic Transcripts
- Three referees with physical /Telephone contact addresses
- Copy of National ID and diploma certificate and practicing licence where applicable