Assistant Risk Consultant Medical - Claims

Recruiter / Employer: Zamara Kenya
Contract: Permanent
Salary: Confidential
Status: Expired

In more detail, the areas of responsibility include:

  • Claim data entry by registering (scanning/coding/indexing/batching) documentation into the system for adjudication vetting and settlement - member validity.
  • Timely Logging in claim data into the system, for ease of management and reference.
  • Following up for settlement of claims within agreed turnaround time.
  • Provider management and training on claim processes and document facilitation.
  • Reconciliation of accounts with various providers to ensure compliance to the set guidelines on credit allowance.
  • Provide data reports collected from various monitoring tools assigned to the role e.g., weekly and/or monthly reports.

 The following qualification is preferred:

  • Diploma or undergraduate qualification in any medical course (Nursing/Clinical medicine).
  • General understanding of the insurance industry is an added advantage.
  • Certificate of Proficiency in Insurance will be an added advantage. 
  • Microsoft Office Skills.
  • Good Listening Skills.
  • Problem Solving Skills.
  • Strong communication skills both written and verbal.
  • Interpersonal Skills.

The following personal qualities are preferred:

  • Ability to be resourceful and proactive in dealing with issues that may arise.
  • Ability to organise, multitask, prioritise, and work under pressure.
  • Excellent time management skills.
  • Ability to deliver on Customer Focus.
  • Ability to maintain confidentiality.
  • Well-groomed and presentable.
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