Claims Analyst at

2 weeks ago


Nairobi, Nairobi Area, Kenya Britam Full time
Britam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi

Job Purpose:


Reporting to the Claims Manager, the incumbent will be responsible for customer satisfaction by increased personal contact with clients in hospital and reduce turnaround time in processing of medical claims and enhance cost effective care of medical claims.


Key responsibilities:
Posting reimbursements and provider invoice details into the Mashinani System.
Maintain close contact with appointed health care service providers to ensure strict compliance with agreed procedures and guidelines.
Ensure that healthcare providers have adequate claim forms to serve members.
Carry out vetting and verification of outpatient and inpatient claims.

Ensure that the panel of doctors is strictly adhered to by clients and hospitals in order to reduce claims costs.

Enlisting providers on panel.
Approval of emails and pre-authorisations within 24 hours for scheduled requests and promptly for emergency approvals.
Assess medical claims documents for authenticity and process payments within set service levels.
Maintain accurate records on medical claims.
Manning of the 24hr helpline.

Delegated Authority:
As per the approved Delegated Authority Matrix

Key Performance Measures:
Prompt response to emails and approvals.
Prompt response to emergency line calls.
Cost savings through proper vetting of claims.
Timely processing of claims within set targets
Promote customer satisfaction and retention.

Requirements
Knowledge, experience and qualifications required

Bachelor's degree in Nursing or Clinical Medicine.
Proficiency in computer / software packages e.g. Microsoft word and Excel.
Strong inter-personal skills and ability to work in a team-oriented and collaborative environment.
Confident, articulate and with strong communication skills.

Technical/ Functional competencies:
Knowledge of insurance products.
  • Claims Analyst at

    2 weeks ago


    Nairobi, Nairobi Area, Kenya Stratostaff Full time

    At Stratostaff we design, implement and manage workforce solutions for large, specialized or routine staff complements giving you the opportunity to focus on your core business.At Stratostaff we design, implement and manage workforce solutions for large, specialized or routine staff complements giving you the opportunity to focus on your core...

  • Claims Analyst at

    1 month ago


    Nairobi, Nairobi Area, Kenya Stratostaff Full time

    At Stratostaff we design, implement and manage workforce solutions for large, specialized or routine staff complements giving you the opportunity to focus on your core business.At Stratostaff we design, implement and manage workforce solutions for large, specialized or routine staff complements giving you the opportunity to focus on your core...


  • Nairobi, Nairobi Area, Kenya Madison Group Limited Full time

    Madison Group Limited is a locally owned financial services holding company that specializes in Insurance and wealth management services. The Group comprises of Madison Life Assurance Kenya Limited, Madison General Insurance Kenya Limited, and Madison Investment Managers Limited. Madison Life Assurance Kenya was originally incorporated under Kenyan Laws in...


  • Nairobi, Nairobi Area, Kenya Madison Group Limited Full time

    Madison Group Limited is a locally owned financial services holding company that specializes in Insurance and wealth management services. The Group comprises of Madison Life Assurance Kenya Limited, Madison General Insurance Kenya Limited, and Madison Investment Managers Limited. Madison Life Assurance Kenya was originally incorporated under Kenyan Laws in...

  • Fraud Analyst

    1 month ago


    Nairobi, Nairobi Area, Kenya Cigna Full time

    Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the worldRole Summary:As Fraud Analyst within Payment Integrity Team you will be directly supporting Cigna's affordability...

  • Data Analyst at

    2 weeks ago


    Nairobi, Nairobi Area, Kenya mTek Services Full time

    mTek Services is an innovative Mobile Application - a platform which provides an entirely paperless ecosystem for the insurance industry. Our solution allows customers to purchase Insurance directly from the Insurer, file for claims directly from the convenience of their smart device thus increasing efficiency and can capture critical data on claims from...

  • Data Analyst at

    1 month ago


    Nairobi, Nairobi Area, Kenya mTek Services Full time

    mTek Services is an innovative Mobile Application - a platform which provides an entirely paperless ecosystem for the insurance industry. Our solution allows customers to purchase Insurance directly from the Insurer, file for claims directly from the convenience of their smart device thus increasing efficiency and can capture critical data on claims from...


  • Nairobi, Nairobi Area, Kenya Turaco Full time

    Turaco is a micro-insurtech company changing healthcare financing in emerging markets. We provide simple, affordable health and life insurance to low-income earners, distributing our products through partnerships with leading businesses in Kenya and Uganda. Our mission is to act as a safety net, freeing people from the fear of health-related financial...

  • Data Analyst at

    2 months ago


    Nairobi, Nairobi Area, Kenya United Nations Office at Nairobi (UNON) Full time

    United Nations Office at Nairobi: Human Resources AnalystGenerate Reports and Visualizations: Create comprehensive reports and visualizations to effectively communicate insights to HR stakeholders.Analysis and Reporting: Develop and implement analysis, reporting, and quality control of HR service delivery.Dashboard Design: Design HR-relevant dashboards and...

  • Financial Analyst

    2 weeks ago


    Nairobi, Nairobi Area, Kenya Aquantuo Full time

    ABOUT THE COMPANYAquantuo is an international courier & package delivery company that provides customized end to end air freight & sea freight shipping services between the USA/Ghana/Kenya.JOB SUMMARYWe are seeking a highly motivated Finance Analyst to join our team. The Finance Analyst will be responsible for providing financial analysis and support to the...

  • Financial Analyst

    1 month ago


    Nairobi, Nairobi Area, Kenya Aquantuo Full time

    ABOUT THE COMPANYAquantuo is an international courier & package delivery company that provides customized end to end air freight & sea freight shipping services between the USA/Ghana/Kenya.JOB SUMMARYWe are seeking a highly motivated Finance Analyst to join our team. The Finance Analyst will be responsible for providing financial analysis and support to the...


  • Nairobi, Nairobi Area, Kenya Apollo Life Assurance - APA Insurance Full time

    Apollo Group (Apollo Investments Limited)was an idea born from the need to harness synergies across the insurance business. Built on commitment, integrity and innovation, it has risen to be one of the leading financial groups in East Africa. Apollo Investments Limited (AIL) includes APA Insurance (Kenya and Uganda).PURPOSE:Responsibilities of the Actuarial...

  • Payroll Analyst

    2 weeks ago


    Nairobi, Nairobi Area, Kenya Athena Full time

    ABOUT THE COMPANYAthena empowers the fiercely ambitious to reach their next 10x. We hire and train exceptional Philippines and Kenya-based Executive Partners (100% Remote Work).Athena Executive Partners are matched 1:1 with industry leaders, startup founders, and driven up-and-comers. These partnerships are powered by 10x delegation training. The result is...

  • Payroll Analyst

    1 month ago


    Nairobi, Nairobi Area, Kenya Athena Full time

    ABOUT THE COMPANYAthena empowers the fiercely ambitious to reach their next 10x. We hire and train exceptional Philippines and Kenya-based Executive Partners (100% Remote Work).Athena Executive Partners are matched 1:1 with industry leaders, startup founders, and driven up-and-comers. These partnerships are powered by 10x delegation training. The result is...

  • Legal Analyst at

    1 month ago


    Nairobi, Nairobi Area, Kenya Kenya Orient Insurance Limited Full time

    The company was incorporated in 1982 by the Al Fateem Group of Dubai and was later acquired by Kenyans in 1988. Kenya Orient Insurance was then formed in 2004 after a transfer of ownership from the previous proprietors to its current owners. We have since enjoyed steady growth as a company and are fast becoming a force to reckon with in the industry.OVERALL...


  • Nairobi, Nairobi Area, Kenya Insurance Regulatory Authority (IRA) Full time

    To be the leading insurance industry regulatorMission:To effectively regulate, supervise, develop the insurance industry and protect insurance beneficiaries.Job PurposeThe position is responsible for assessing and monitoring the financial soundness of the industry, conducting macro-prudential surveillance, data analytics, reporting, and publication with the...

  • Actuarial Analyst

    1 month ago


    Nairobi, Nairobi Area, Kenya Jubilee Insurance Full time

    Jubilee Insurance was established in August 1937, as the first locally incorporated Insurance Company based in Mombasa in 1937. Jubilee Insurance has spread its sphere of influence throughout the region to become the largest Composite insurer in East Africa, handling Life, Pensions, general and Medical insurance.Job RefNo:JHIL112Role PurposeThe job holder...


  • Nairobi, Nairobi Area, Kenya Old Mutual Full time

    ABOUT THE COMPANYOld Mutual Kenya provides investment, savings, life assurance, asset management, banking and property and casualty insurance in Africa, Europe, the Americas and Asia. We have over 17 million customers and approximately employees.JOB SUMMARYTo carry out valuation of technical liabilities in GI and Health business, capital adequacy...

  • Business Analyst at

    2 weeks ago


    Nairobi, Nairobi Area, Kenya Old Mutual Kenya Full time

    Old Mutual Kenya is based in Nairobi and is part of a larger group that offers solutions in long-term savings, asset management and investment.We offer solutions to individuals and corporates underpinned by our core values which are: Respect, Integrity, Accountability and Pushing beyond boundaries.SummaryReporting to the Underwriting Manager, Health, this...

  • Business Analyst at

    1 month ago


    Nairobi, Nairobi Area, Kenya Old Mutual Kenya Full time

    Old Mutual Kenya is based in Nairobi and is part of a larger group that offers solutions in long-term savings, asset management and investment.We offer solutions to individuals and corporates underpinned by our core values which are: Respect, Integrity, Accountability and Pushing beyond boundaries.SummaryReporting to the Underwriting Manager, Health, this...