Full Time
Old Mutual Kenya is Hiring! Apply Today!
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Old Mutual Kenya is Hiring! Apply Today!

1.Medical Claims Vetter Job

Job Description

To process medical claims focusing on cost control and management of member benefits through vetting and coding inpatient and outpatient bills and capturing them in the company medical business operating system(s).

Key Responsibilities

To process medical claims focusing on cost control and management of member benefits through vetting and coding inpatient and outpatient bills and capturing them in the company medical business operating system(s).

  • Verify, audit, and Vet medical claims for payment for both outpatient and inpatient claims as per the claim’s manual/Standard operating procedure
  • Adhere to the customer service charter manual to ensure compliance with agreed turnaround times
  • Prompt reporting of any identified risks during claims processing for mitigation.
  • Monitor, prevent, and control medical claims fraud/wastages during claims processing
  • Use of data analytics to review cost and quality of service at medical service providers.
  • Hold regular business meetings with service providers to ensure compliance on systems such as smart card systems and agreed tariffs.
  • Evaluate preliminary claim information and revert to broker or insured for more information where necessary to ensure that the correct information is documented for ease in processing of member reimbursement claim
  • Respond to client inquiries within 24 hours of inquiry
  • Communicate and liaise with medical service providers on resolution of disputed claims
  • Any other duties assigned by management.

Skills

  • Medical Claims Vetting, clinical experience

Educations

  • Bachelor of Science in Nursing (BScN) or Diploma in Nursing (KRCHN)

How To Apply

Click Here To Apply

Deadline: 6th Dec 2023

2.Current Customer Service Job

Location: Mombasa, Eldoret

Job Description

  • Enforce underwriting controls including onboarding, certificates, booking of business, and documentation.
  • Implement underwriting guidelines, processes, and procedures to ensure quality underwriting and business.
  • Ensure profitability of the branch through quality control and on-boarding.
  • Quality documentation timely turnaround – TAT.
  • Excellent customer service and retention support.

Key Responsibilities

  • Enforce underwriting controls.
  • Ensure clean and accurate data capture.
  • Timely preparation of quotations and follow-up.
  • Debiting of premiums and processing of policy documents within set timelines.
  • Processing and checking of underwriting Documents.
  • Issuing & signing of Motor Certificates and Yellow cards.
  • Ensure that work is done within the set standards of service and TAT.
  • Give quality customer service to all clients.
  • Safe keeping of security documents.
  • Daily scanning and indexing of emails.
  • Initiating motor valuation and follow-up.
  • Adherence to the credit control policy.
  • Follow up renewals and ensure maximum retention of profitable accounts.
  • Timely processing of refunds and follow-up.
  • 100% Adherence to the authority matrix.
  • Ensure the registry is fully maintained, orderly, and up to date.
  • Ensure compliance with AML and PEP guidelines.
  • Ensure cross-sale and up-sale opportunities are maximized.
  • Perform any other duties as may be required by the management.

Skills & Competencies

  • Basic Underwriting skills and product knowledge.
  • Customer service skills.
  • Good Communication Skills.
  • Computer Literate.

Qualifications  (Academic, Professional, Experience)

Qualifications:

  • Degree preferably insurance.

Experience:

  • 1 year and above.

How To Apply

Click Here To Apply

Deadline: 6th Dec 2023

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