Key Responsibilities
Reviewing, assessing, coding, vetting, approving and processing of all claims.
Capturing claims master information, claims details/line information and claims reference information ensuring claim is processed against the right benefit type and that the right scheme rules are applied.
Detecting any fraudulent claims e.g. overpricing of items or services, overprovision of services and scheme abuse practices.
Communicating part payments and their reasons to providers in advance through the provider management team.
Auditing provider billing practices or high quantity drug reports and advice the claims manager.
Advising other claims handlers on their cases and act as the focal point for claims requiring medical claims knowledge.
Identifying the cost drivers and their trends and inform the claims manager with a view to finding solutions to cost containment.
Responding to internal and external queries in a timely manner.
Education, Experience & Competencies
Holders of a Diploma or Bachelor’s degree preferable in Nursing or Clinical Medicine
Possess at least 2 years relevant work experience.
Holder of a professional certification such as: Insurance professional qualification i.e. AIIK or ACII.
Possess excellent interpersonal skills, attention to details and a team player
If you meet the above the requirements and wish to be part of our vibrant team, please send your application letter and updated CV attaching any testimonials to the email address hrdesk@aar.co.ke.Your application should reach us by 23rd January 2023. Only shortlisted candidates will be contacted.
Apply via :
hrdesk@aar.co.ke
