Claims Analyst at APA Life Assurance Company Ltd

Job Description (adsbygoogle = window.adsbygoogle || []).push({}); Apollo Group (Apollo Investments Limited)was an idea born from the need to harness synergies across the insurance business. Built on commitment, integrity and innovation, it has risen to be one of the leading financial groups in East Africa. Apollo Investments Limited (AIL) includes APA Insurance (Kenya and Uganda). It underwrites General Insurance risks such as Fire, Marine, Aviation, Personal Accident, Motor, Liability, Agriculture, Property, and Micro Insurance. We also underwrite Health Insurance i.e. Corporate, Individual & Family Health Insurance. APA Life Assurance is one of the leading insurance companies in Kenya providing Life Insurance and Pension benefits.SUMMARYTo ensure prompt and fair settlement of all medical claims in accordance with the claims manual and guidelines in order to control claims expenditure and also maintain a good working relationship with service providersKEY PRIMARY RESPONSIBILITIES Vetting and analyzing medical claims as per the scope of cover whilst ensuring strict adherence to set guidelines and TATMonitors service providers’ claims through analytics in view of ensuring they maintain high standards of service deliveryReconciliation of medical providers’ bills & accounts on an ongoing basis or on-demand including visits to providers to sort out contentious bills/ issues REQUIREMENTSACADEMIC QUALIFICATIONS Diploma in Kenya Registered Community Health Nursing/ Clinical medicine/ pharmacy and/ or in any medical-related qualifications. JOB SKILLS AND REQUIREMENTS Computer literate and familiar with high processing speed using standard office software applicationsTeam player with strong interpersonal and persuasive skillsGood Communication and interpersonal skillsGood analytical skills and keenness to detailsExcellent Negotiation skillsEffective decision maker PROFESSIONAL QUALIFICATIONS Certificate of Insurance Proficiency or any Insurance-related qualifications EXPERIENCE At least 3 years’ experience in a busy health Insurance environment with a Claims Vetting & Care management background