CIC Africa Insurance (SS) Ltd, a subsidiary of CIC Insurance Group, is looking to recruit highly skilled individuals to fill the position of Medical Claims Analyst to be based in the Head Office in Kenya. Reporting to the Medical Supervisor – Claims & Care Service Management, the role holder will be responsible for vetting both in-patient and outpatient medical claims for payment.
Key Responsibilities
Vet in/outpatient medical bills/invoices and refer any suspicious claims to the supervisor.
Batch outpatient invoices on the system and adjust amount payable as per the vetting findings.
Check and reject incomplete invoices and return with supporting documents to service providers.
Negotiate, adjust and update service providers on their costs and accounts status.
Reconcile statements of accounts for service providers; advising accounts and service providers on unpaid/underpaid bills.
Review claims reserves on a continuous basis in view of new developments.
Attend to customer queries and complaints promptly and professionally.
Recommend risk improvement measures to the underwriter to take appropriate action.
Requirements
Bachelor’s degree in a related field or a Diploma in Nursing / Diploma in Clinical Medicine.
Minimum of 3 years of relevant experience.
Registered Nursing Diploma is required.
Technical competence in insurance.
Basic knowledge of regulations by the industry regulators.
Skills
Excellent communication and presentation skills.
Strong problem-solving and analytical skills.
Excellent interpersonal and negotiation skills.
Computer literate in MS Office and other office applications.
Understanding of the working environment and competitors.
How to Apply
Interested and qualified candidates should apply through the CIC Insurance careers portal by visiting careers.cicinsurancegroup.com.
How to Apply
Interested and qualified candidates should apply online through the CIC Insurance careers portal at careers.cicinsurancegroup.com.
