Nature and scope

The position reports to the Supervisor Medical Claims. The jobholder is responsible for maintaining constant contact with hospitals to ensure continuous well being of all stakeholders and handling of medical claims with efficiency and accuracy.

Key responsibilities

• Assess inpatient medical claims documents for authenticity.

• Data entry for medical claims records.

• Carry out effective case management.

• Process medical claims documents for payment.

• Issuing of undertaking letters/declines promptly to the hospital.

• Organize and conduct health talks.

• Respond to client enquiries within 24 hrs of enquiry.

• Ensure claims are processed within 30 days.

• Visit health care institutions around Nairobi to confirm admissions.

• Visiting of Providers outside Nairobi upon allocation of schedule.

• Liaise with the hospitals and doctors on prompt submission of the admission summary form, monitor procedures being carried out on patients and see to the general well- being of the patient.

• Prompt collection of claims paid out of policy liability.

• Processing reimbursements.

• Any other duties assigned by supervisor – medical claims.

Qualifications

• Bachelors Degree/ Diploma in Nursing.

• Computer literacy.

An attractive remuneration package will be offered to successful candidates. In-house training and a professional office environment will also be offered.

If you possess the necessary qualifications and experience, please email your application detailed CV indicating current position and telephone contacts with names and addresses of three professional referees to This e-mail address is being protected from spambots. You need JavaScript enabled to view it not later than 30th March 2012.

Only shortlisted candidates will be contacted.