Job Purpose:

To enhance customer satisfaction by reducing turnaround time in processing of medical claims and enhance cost effective care whilst provide quality care.

Key Responsibilities:

• Vetting of claims to ensure only valid claims is settled.
• Prompt data capture of both Inpatient and outpatient claims in the system.
• Ensure reimbursements claims are posted within 14 days of receipt.
• Respond to client queries on any issues raised within scope of the job.
• Carry out verification of outpatient claims.
• Ensure that the panel of doctors is strictly adhered to by clients and hospitals in order to reduce claims costs.
• Assess medical claims documents for authenticity and process payments within set service level agreements.
• Liaise with Accounts/disbursement to ensure safe and timely dispatch of reimbursement claims cheques to clients.
• Maintain accurate records on medical claims.
• Manning of the 24hr helpline.
• Offer excellent customer service.
• Assist with posting of outpatient claims.

Knowledge, experience and qualifications required

Qualifications, Knowledge, Experience:

• Bachelor’s Degree.
• Good analytical skills and report writing skills.
• Computer literate.
• 2 years’ relevant experience.

Other desirable attributes:

• Strong personality with interpersonal sensitivity.
• Good written and verbal communication skills.
• Proactive.
• Team player.
• Strong negotiating skills.
• Assertive and confident.
• Self-starter.
• Creative & open-minded.
• High level of numeracy and strong analytical skills