Medical Claims Analyst , KCB

Medical Claims Analyst

The Position

Reporting to the Healthcare Administrator-Bancassurance, the role holder will be responsible for day to day engagement with medical providers to ensure quality healthcare provision to members of medical schemes as well as analysis of medical bills submitted for settlement.
Key Responsibilities

• Vetting and analysing medical claims as per scope of cover whilst ensuring strict adherence to set guidelines and TAT
• Preparation of members’ reimbursement claims and payment of the credit medical providers
• 24 hour on-call services in management of medical scheme issues
• Preparation of utilization reports and other reports as required by member / client
• Maintenance of the filing of the medical schemes data/ payment vouchers to ensure proper record keeping
• Reconciliation of medical providers’ bills & accounts on an ongoing basis or on demand including visits to providers to sort out contentious bills/ issues

• Updating staff medical statements and ensuring all utilizations are captured on a timely basis
• Arranging for emergency evacuations for medical scheme members country wide
• Professional assistance to all the staff members/dependants with Chronic ailments and facilitating follow up in specialists’ clinics.

Position’s Requirements

• Diploma in Kenya Registered Community Health Nursing nursing/ clinical medicine/ pharmacy and/ or in any medical related background i.e. Pharmacy, medical laboratory or clinical medicine
• At least 3 years’ experience in a busy health Insurance environment with Claims Vetting & Care management background
• Training in Basic and Advance Life Support
• Computer literate and familiar with high processing speed using standard office software applications
• Mature, team player with strong interpersonal and persuasive skills
• Good planning and organization skills with the ability to deliver effectively under strict deadlines
• Excellent Listening and Communication skills
• Accuracy and attention to detail
• Ability to develop working relationships with a wide range of internal and external partners
• Maintaining strict confidentiality and integrity of all information he/she comes across in the execution of their duties

The above position is a demanding role which the bank will provide a competitive package for the successful candidate. If you believe you can clearly demonstrate your abilities to meet the criteria given above, please submit your application with a detailed CV, stating your current position, remuneration level, e-mail address and telephone contacts quoting the job title/reference in the subject field torecruitment@kcb.co.ke.

To be considered your application must be received by Dec. 13, 2013.

Only short listed candidates will be contacted.

JOB REF: CBOK 282013