Job Field: Sector in Insurance , Medical / Healthcare
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Medical Services Manager
The jobholder will oversee effective deployment of the cost management and profitability strategies for the healthcare business to achieve the budgeted claims ratio, optimize operational efficiencies in business processes in Medical Services Department which includes Care Management, Call Centre and Provider and Wellness Management and deliver exceptional customer experience. Key Responsibilities Develop and implement the…
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Provider Relations & Wellness Assistant
Duties & Responsibilities Key responsibilities for the position are as hereunder: To co-ordinate the contracting process that includes follow up of contracts from provider end and internally and ensure all the relevant documents are in order. To co-ordinate the provider compliance process that includes updated KYC’S Managing all provider communication that includes appointment letters, welcome…
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Provider Relations & Wellness Assistant
Duties & Responsibilities Key responsibilities for the position are as hereunder: To co-ordinate the contracting process that includes follow up of contracts from provider end and internally and ensure all the relevant documents are in order. To co-ordinate the provider compliance process that includes updated KYC’S Managing all provider communication that includes appointment letters, welcome…
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Claims Management Officer
Job Summary: The main purpose of the job is to authenticate billings for patients under cash, insurance and NHIF cover in an accurate and timely manner for claims processing. Job Specifications/Qualification Degree or Diploma in Nursing/Clinical Medicine from a recognized institution Proficiency in use Health Management Information Systems Computer Literacy (Microsoft packages) Previous experience in…
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Case Managers Claims Assessors
Reporting to: Principal Officer – Kenbright Claims Settlement Agency Key Responsibilities: Coordinate and manage patient care plans. Work with healthcare providers to optimize treatment outcomes and control costs. Assess the necessity and appropriateness of medical procedures and treatments. Ensure that healthcare services meet established guidelines and standards. Conduct audits to ensure compliance with medical policies…
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EMC Case Management Assistant EMC Underwriting Assistant EMC Medical Claims Assistant Business Processing and Compliance Assistant Credit Control Assistant Medical Contact Centre Assistant Care Management Assistant Assistant Claims Officer Underwriting Assistant Corporate Sales Executive
Job Purpose: Controlling and Managing policies through case management to ensure quality and cost effective care, client service, provider management, processing and payment of claims. Key responsibilities: Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration). Interact with clients and service providers to ensure that the care is given within…
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Claims Officer (Medical Department) – FAK Senior Claims Officer (Medical Department) – FAK
Job Summary To support the Head of Medical Claims in the Medical Department by providing operational support in the Medical Department processes. To process and settle insurance claims in a fast, fair and courteous manner to ensure customer satisfaction, company profitability and good corporate image Job Description Claims vetting and approval Receiving and registering incoming…
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Assistant Case Manager
PURPOSE OF THE JOB Provide superior customer experience by efficiently and effectively managing clients and medical provider requests, queries and enquiries. To process medical claims submitted to the company and determine whether claims meet eligibility standard of the company. KEY RESPONSIBILITIES Claims Processing Confirmation of membership, validity, and benefits before processing claims. Capture and vet…
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Case Management Nurse
Job Description To control and manage medical benefit utilization through preauthorization and case management activities and ensure quality, appropriate cost effective care and good customer service KEY TASKS AND RESPONSIBILITIES Pre-authorize scheduled and nonscheduled admissions within the set guidelines. Negotiate/discuss professional fees as appropriate for each admission. Set the appropriate parameters for each admission (claim…
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Senior Case Manager – Care Management, Wellness and CDMP
PURPOSE OF THE JOB Collaborate with medical clients, intermediaries, and medical service providers to facilitate access to quality, timely, effective, and cost-efficient healthcare services with the aim of achieving business growth, profitability, and customer retention. Improve management and outcome of specified medical condition while containing cost for clients with newly diagnosed or long-standing medical conditions.…