Medical Claims Analyst

ABOUT THE COMPANY

The year 1978 proved to be a milestone for the Insurance Sector in the region , Indian Insurance Companies operating in Kenya decided to merge and form a vibrant joint venture with moral and financial support from leading local business elite. The idea became reality on 6th December 1978 with the birth of Kenindia Assurance Company Limited.

JOB SUMMARY

MINIMUM QUALIFICATIONS - KNOWLEDGE AND EXPERIENCEUndergraduate Degree in any Related FieldAIIKCPAAt least 2 years of relevant experienceMethod of ApplicationTo apply, send your Curriculum vitae (CV) and cover letter and quote the job title on the subject of the e-mai

RESPONSIBILITIES

Ensuring daily recording of incoming medical bills.Receiving claims and checking corresponding policies in line with the claim.Reconciliation of Medical service providers accounts.Registration of claims and reserving adequate estimates.Ensuring the ailment is covered under the policy.Ensuring the treatment and the drugs dispensed are in line.Ensuring the with-holding Tax by Doctors’ is complied with before cheque dispatch.Ensuring the appointment of investigators for authenticity of questionable claims.Ensuring the facility is registered within the medical practitioners and dentists board.Preparing claim notes for vetting by the medical personal and approval/comments by the HOD.Ensuring dispatch of discharge voucher to the client and communicating by writing on the liability.Ensuring claims are settled within approved company guidelinesEnsuring proper dispatch of settlement cheques.Ensuring that the files are sent back to the filling room.Reconciling of claim statements from stakeholders for correct position of their accountsPreparing remittances for any Medical claims cheques before dispatch.Ensuring proper records of outgoing settlement cheques to various stakeholders.Ensuring service providers meet agreed service timeline.Ensuring customers service to both internal and externalAnd any other duties assigned

REQUIRED SKILLS

Compliance, Risk analysis, Customer service, Handling claims

REQUIRED EDUCATION

Bachelor's degree