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Medical Claims Analyst At Cic Insurance

Technoserve Kenya

NGO / Non-Profit Associations full time Nairobi Posted 18 hours ago

CIC Insurance Group Limited, commonly referred to as CIC Group, is an insurance and investment group that operates mainly in Kenya, Uganda, South Sudan and MalawiAbout the Role 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 vetting both in/ 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 and  Recommend risk improvement measures to the underwriter to take appropriate action.  Who We’re Looking For Essential Knowledge/Skills and Experience Required: 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 – Required   Excellent communication and presentation skills  Problem solving skills  Excellent interpersonal skills   Good negotiation skills  Good analytical skills  Computer literate in MS Office and other office applications  Understanding of the working environment /competitors  Technical competence in insurance   Basic knowledge of regulations by the regulators