Job Field: Sector in Insurance , Medical / Healthcare
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Case Manager Senior Wellness Coordinator, Population Health
Job Ref. No: JHIL163 Role Purpose The Case Manager will be responsible for monitoring and managing the utilization of medical services to ensure appropriate and cost-effective care while maintaining quality standards; Conduct clinical reviews of cases, assess treatment efficacy, ensure adherence to best practices, and recommend adjustments when needed. Key Responsibilities Execute robust case management…
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Assistant Manager Health Claims
Job Purpose: Overall managing medical claims processes and procedures through the use of effective techniques to achieve the objectives of claims cost control and operational efficiency. Key responsibilities: Oversee the claims process flows to ensure efficiency in processing of claims as per the company medical claims procedure manuals. Verification and audit of outpatient and…
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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…