Optometry Officer

ABOUT THE COMPANY

For more than three decades, the CIC Insurance Group has dependably shouldered the risks of the Kenyan people through providing insurance services that help you plan for life stage needs, secure your future, protection you against rising health expenses and safeguard your investments.
Besides giving our customers peace of mind, we continuously work towards living up to our commitment to safeguard the interests of individuals and businesses that insure with us by paying claims promptly. Our consistent adherence to our motto “We Keep Our Word” has made us the fastest growing insurance company in Kenya and the 2nd largest insurer by market share.

JOB SUMMARY

Who We’re Looking ForEssential Knowledge/Skills and Experience Required:Diploma in Optometry and Vision SciencesLicensed by KHPOAPMinimum of 3 (three) years relevant experience in a busy medical environment  Experience in an insurance firm is an added advantageCustomer experience training will be an added advantageKey Competencies:High attention to detail and accuracyAnalytical & problem – solvingGood communication and stakeholder management skills.

RESPONSIBILITIES

 Accurate adjudication of all Optical claims in accordance to Scheme’s policy provisions.Maintenance of high servicing levels by issuing approvals within 15minutes and sharing daily optical TAT reportIn-depth analysis of claim trends and maintenance of accurate revisit registersRespond to Optical related calls and email complaints within 24hours of notification and timely escalation as per escalation matrixFacilitate issuance of letters of undertaking for scheduled ophthalmological procedures and cases requiring day case and inpatient ophthalmology careInstitutionalize robust optical and ophthalmological cost management initiatives through discount negotiation, fraud detection and investigation, costing, and optimization of SHA ophthalmological packages.Conduct cost versus clinical validation of optical prescriptions, lens and frames choices, diagnoses requirements to prevent inappropriate costing, or incongruent prescriptions.Conduct regular Optical provider forensic mystery shopping and physical audits of at least 5 providers quarterly and share audit report with management.Negotiate at least 5 preferred Opticians per quarter and help drive traffic to the preferred panelAny other duty as may be assigned by the supervisor.

REQUIRED SKILLS

Medicine, Eye and vision care, Eye treatment, Optometry

REQUIRED EDUCATION

Diploma, Associate's degree