Claims Representative

6 days ago

Nairobi, Nairobi Area, Kenya The Cigna Group Full time 1,200,000 - 2,400,000 per year
The job profile for this position is Claims Representative, which is a Band 1 Professional Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

YOUR JOB

  • As Claims Representative you analyze claims in respect of client medical costs.
  • You adjudicate medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
  • You analyze reimbursements according to the contract agreements and assess, code and calculate them using a computerized claims processing system.
  • You pass communications to the communication team to solve or preempt any possible issues with your stakeholders.
  • Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your supervisor when this is not achievable.
  • You take responsibility/ownership of complex cases. You handle them accurately and with the personal attention that is required.
  • You keep your knowledge up to date with respect to the medical information necessary for handling claims and you take part in trainings to ensure you are up to date with policies, processes and other required information.
  • You are attentive to inaccuracies in the files and communicate them to your team leader/departmental head.
  • Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible.
  • Carry out other adhoc tasks as required in meeting business needs.

YOUR PROFILE

  • You have an active knowledge of English which you are not afraid to use in interactions with both internal and external parties. knowledge of French language is an added advantage.
  • You are prompt, precise and good with numbers.
  • A first experience in analytical work is a plus
  • You have an eye for detail and you are known to work meticulously.
  • You can work individually and make correct decisions, always keeping customer centricity as guiding principle through everyday work;
  • You are flexible and quickly adapt to ever-changing work processes.
  • You are aware of the sensitivity and delicacy of the information you handle.
  • You are proactive, ensuring a smooth workflow and taking into account the needs of your client.
  • You are a team-player, sharing best practices on processes and procedures with your colleagues.
  • You can familiarize yourself quickly with computer applications.
  • Diploma or degree in a related field.

Please note that you must meet our posting guidelines to be eligible for consideration.  Policy can be reviewed at this link.

  • Claims Representative-2

    2 weeks ago

    Nairobi, Nairobi Area, Kenya The Cigna Group Full time 360,000 - 1,080,000 per year

    We are looking for a detail-oriented Claims Representative to join our claims team. You will be responsible for verifying information and corresponding with agents and beneficiaries. You will also handle client inquiries, review policies, determine coverage, calculate claim amounts, and process payments.To be successful as a claim's processor, you should...

  • Claims Representative-2

    2 weeks ago

    Nairobi, Nairobi Area, Kenya Cigna Healthcare Full time 1,200,000 - 2,400,000 per year

    We are looking for a detail-oriented Claims Representative to join our claims team. You will be responsible for verifying information and corresponding with agents and beneficiaries. You will also handle client inquiries, review policies, determine coverage, calculate claim amounts, and process payments.To be successful as a claim's processor, you should...

  • Claims Representative

    6 days ago

    Nairobi, Nairobi Area, Kenya The Cigna Group Full time 1,200,000 - 2,400,000 per year

    You will be responsible for preparing claim forms, verifying information, and corresponding with agents and beneficiaries. You will also handle client inquiries, review policies, determine coverage, calculate claim amounts, and process payments.To be successful as a claim's processor, you should have excellent organizational and interpersonal skills. You...

  • Claims Representative

    1 week ago

    Nairobi, Nairobi Area, Kenya Cigna Healthcare Full time 900,000 - 1,200,000 per year

    You will be responsible for preparing claim forms, verifying information, and corresponding with agents and beneficiaries. You will also handle client inquiries, review policies, determine coverage, calculate claim amounts, and process payments.To be successful as a claim's processor, you should have excellent organizational and interpersonal skills. You...

  • Chief Operations Officer

    2 weeks ago

    Nairobi, Nairobi Area, Kenya Britam Full time 1,500,000 - 4,500,000 per year

    Job Purpose:The Chief Operations Officer will be accountable for Overseeing the technical and non-technical operations supporting General Insurance Business with a core mandate to drive a robust underwriting and claims function to drive growth in underwriting profitability.The role holder will also be responsible for setting and driving strategic direction...

  • Medical Advisor

    2 weeks ago

    Nairobi, Nairobi Area, Kenya The Cigna Group Full time $90,000 - $120,000 per year

    The Medical Advisor is a member of the medical team, part of IHT, who develops and manages health and wellness programs for Cigna customers. Together with a team of nurses and physicians she/he will ensure attainment of quality, production, timeliness, customer advocacy, cost containment goals, and excellent customer satisfaction for both internal and...

  • Key Account Manager

    6 hours ago

    Nairobi, Nairobi Area, Kenya Jumia Group Full time 1,200,000 - 3,600,000 per year

    About Jumia:Jumia is a leading pan-African e-commerce platform. Its mission is to improve the quality of everyday life in Africa by leveraging technology to deliver innovative, convenient and affordable online services to customers, while helping businesses grow as they use Jumia's platform to better reach and serve customers.Jumia is built around a...

  • Senior Specialist

    2 days ago

    Nairobi, Nairobi Area, Kenya Novonesis Full time 1,200,000 - 3,600,000 per year

    Are you ready for a new beginning?We need your talent, knowledge and dedication to better our world with biology.Our purpose points the wayIn Novonesis, we know that solutions rooted in biology can help solve humanity's biggest challenges. Since we began more than a century ago, this has been our guide. It's how we've gotten so far. And it's how we'll...

  • CEO – Regional Insurance Brokerage

    2 days ago

    Nairobi, Nairobi Area, Kenya Dorbe-Leit Consulting Limited Full time 900,000 - 1,200,000 per year

    Company DescriptionLocation:Nairobi, KenyaRegion:East Africa, based in KenyaReports to:Board of DirectorsType:Full-Time Executive RoleSector:Financial Services – Insurance BrokingPackage:Competitive with performance-based incentives tied to transformation KPIsSize:Annual turnover Kshs 1.2B. 40 staff.Position SummaryWe are seeking a bold, values-driven,...

  • Entrepreneurship Development Manager

    6 days ago

    Nairobi, Nairobi Area, Kenya ALX Africa Full time 1,500,000 - 3,000,000 per year

    ABOUT ALX AFRICAALX Africa, a non-profit organisation under the ALX Foundation, is dedicated to unlocking the potential of Africa's digital future. Formerly part of Sand Tech Holdings, we've embarked on an independent journey to provide world-class tech skills training and career acceleration programmes. Our mission is to bridge the digital divide, upskill...