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Corporate & Claims Insurance Officer

2 months ago

Nairobi, Nairobi Area, Kenya Emerge Egress Consulting Full time
Emerge Egress Consulting is a Management and Training Consulting established in 2017 (herein referred as EEC). EEC specializes in offering tailored and proficient HR Management training and team building services.

Role Objective

A hospital in Nairobi is seeking to hire a competent individual who is conversant with the smart system and ability to handle claims in the medical field effectively.

Core Duties and Responsibilities

Responsible for analyzing, vetting and processing insurance claims to the satisfaction of clients in accordance with policy terms and conditions .

Ensuring that claims made on insurance policies are dealt with promptly and efficiently.
Appointment scheduling, managing schedules for doctors, specialists, and other healthcare providers.
Booking and coordinating patient appointments, rescheduling as needed, and

Ensuring efficient use of clinical resources, performing clerical duties such as fax, copying documents, filing etc and efficient operations.

Maintaining accurate and confidential patient records in compliance with healthcare regulations.
Handle. Complaints and problem solving for various arising issues.
Managed high volume phones and various forms of correspondences efficiently.
Updating patient information and hospital databases effectively.
Billing and insurance coordination, assisting with patient billing processes, verifying insurance coverage, and handling billing inquiries.
Processing accurate documentation and requirements for reimbursement with the relevant parties.
Manning front desk reception welcoming visitors, patients and other stakeholders and providing the necessary assistance.
Responding to phone calls, emails, and other social media correspondence as required.
Generating receipts and invoices and any other documents as needed.
Providing general administrative support to hospital staff and departments.
Any other duties assigned from time to time.

Job Specifications
Qualifications

At least a Diploma in Business Administration, Communication, or elated field
At least 2 years' relevant work experience.
Proficiency in MS Office Suite & CRM tools.
Must possess not less than 2yrs experience working with SMART systems that handle health insurance companies.

Key Competencies

Great communication skills
Patience
Empathetic Skills.
Customer Relationship Skills
Problem Solving Skills