Stratostaff Health Insurance Claims Analyst Jobs in Nairobi, Kenya

Stratostaff Health Insurance Claims Analyst Jobs in Nairobi, Kenya

Profile Introduction

Our client, a leading financial and health insurance company seeks to bring on board an Claims Analyst.

The role will be responsible for processing medical claims with a focus on accuracy, cost containment, risk management and customer excellence.

Key Areas of Responsibility

Review, assess, authenticate and capture outpatient and inpatient claims as per the claims manual and within the set TATs

Timely scanning, barcoding and batching of received claims

Processing of reimbursements within the set TATs

Conduct quality assurance process before batches are authorized for pay run

Notify brokers and clients of pended and declined claims within set timelines

Manage pended and declined claims

Liaise with agents, brokers and service providers on matters arising on claims

Ensure all claims documents are archived in the relevant systems

Maintain claims production within set targets

Generate daily health claims status report

Storage of all correspondence in Medware system

Monitoring and processing of NHIF enhanced benefits for cost containment

Recording and monitoring of roaming and counter-guarantee claims.

Customer service – address clients’ queries in form of telephone queries, letters, emails and walk –in clients.

Maintain

proper department standards, discipline and confidentiality regarding patients’ illness

Minimum Qualifications:

Bachelor’s degree/ Diploma in medical, insurance or business-related discipline

Progress towards Diploma in Insurance will be an added advantage.

1 years’ experience in medical claims management in insurance/hospital setting

Core Competencies

Knowledge of insurance concepts

Knowledge of medical claims processes and procures

Knowledge of insurance regulatory requirements

Stakeholder management

Customer service

Good Microsoft Excel skills and math aptitude

Delivering results and meeting customer expectations

Interpersonal skills

Planning and organizing

Presenting and communicating information

Persuading and influencing

Supervisory skills

Adhering to principles and values

How to Apply

If you are qualified and up to the challenge, please send your CV to vacancies@stratostaff.co.ke by 5 p.m, 27th March 2023.

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