Claims Clerk – Medical
Purpose of the Job
To efficiently handle all claims and settle within stipulated timelines.
Duties & Responsibility
- Correct record keeping of all received invoices, sorting and stamping when received.
- Ensuring that all invoices captured are vetted and approved by the medical team so that they pay the correct amounts.
- Ensure that proper and complete instructions on claim eligibility are provided on pre assessment sheet for proper and timely settlement of the claim.
- To have market awareness of prices and costs within the private medical environment within locations handled.
- Provide feedback to Team Seniors of any errors recorded with suggestions for improvement Speed and accuracy in data capturing, picking any queries and reporting.
- To update system notes for claim assessed accurately and timely.
- Ensure correct and timely reports are provided to Team Seniors for day to day work management in the required format.
- To actively participate in regular Team meetings and daily huddles and provide support to Team Seniors
- To provide support and assistance to other functions of the department as and when required by Team Seniors and Manager.
- To resolve any technical or contentious claims within the boundaries of claims knowledge and policy held.
- Check claims within authority limits and record errors.
- To fully investigate all information that is received concerning claims and to query any anomalies that may occur.
- Email queries and telephone calls to be auctioned within 24hrs.
- Refer all complaints to Claims Supervisor for action/advice
- To manage and develop the internal and external relationships which allow the claims function to operate effectively and efficiently.
- To promote the best image for the company through the professional appearance and behavior and adhere to company standards and procedures.
- To maintain the highest level of personal conduct.
- To assist in any Team Projects
Academic Qualifications
- Minimum of a Bachelor’s degree in a business related field.
Professional Qualifications:
- Good progress towards the achievement of a diploma in Insurance from the College of Insurance or Chartered Insurance Institute (UK) is an added advantage.
Relevant Work Experience
- At least 2 year working experience in a medical facility
Skills/ Knowledge
- Excellent verbal communication
- Expertise and experience in medical insurance
- IT Skills
- Update with the current trends on cost of the different service providers
- Good knowledge of medical insurance and products
- Knowledge in new trends, diseases and new treatments (vaccines) in the region
- Excellent customer service skills
If you meet the above
requirements and consider yourself up to the challenge, please email
your application and a copy of your CV clearly indicating on the subject
of your email the job Ref No.
For example: Ref: Application for Claims Clerk – Medical Position to:
The Group Human Resources Manager
CIC Insurance Group Ltd
Strictly through Email to: recruitment@cic.co.ke
The application should reach us by close of business on 26th April 2013. Please note only shortlisted candidate will be contacted. If you do not hear from us by 15th May 2013consider your application unsuccessful.
For example: Ref: Application for Claims Clerk – Medical Position to:
The Group Human Resources Manager
CIC Insurance Group Ltd
Strictly through Email to: recruitment@cic.co.ke
The application should reach us by close of business on 26th April 2013. Please note only shortlisted candidate will be contacted. If you do not hear from us by 15th May 2013consider your application unsuccessful.
