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  • Posted: Apr 20, 2022
    Deadline: Apr 28, 2022
  • Never pay for any CBT, test or assessment as part of any recruitment process. When in doubt, contact us

    CIC Insurance Group Limited, commonly referred to as CIC Group, is an insurance and investment group that operates mainly in Kenya, Uganda, South Sudan and Malawi
    Read more about this company


    Assistant Manager – Claims Vetting



    Responsible for supervision of claims vetting and audit to ensure all claims paid are according to the company policy and guidelines.


    • Coordinate and ensure cost containments measures/targets set within the claims vetting section are achieved.
    • Ensure claims vetting and audit daily output targets are achieved and overall levels are maintained within acceptable ranges.
    • Prepare weekly and Monthly reports on claims output, individual and group cost savings, rejections and exclusions.
    • Ensure candidates for wellness and Chronic Disease management are flagged at claims vetting section based on clinical trends for follow-up by the wellness coordinator.
    • Coordinate with claims registration and provider relations department to ensure payments to providers have been settled within the acceptable timelines as per SLAs.
    • Responsible for communication of inadmissible reimbursement claims on clinical matters to the key stakeholders.
    • Coordinate with provider management team and claims registration section to ensure desired provider reconciliations and sign offs are achieved.
    • Provide appropriate recommendations on provider trends to clinical operations team and management for appropriate action.
    • Monitor claims trends to identify high cost providers and together with provider relations team engage providers to ensure desires trends are achieved.;
    • Recommend risk improvement measures for implementation to the underwriting department by monitoring claims experience trends
    • Resolve customer complaints and disputes swiftly, fairly and diplomatically that concerns claims vetting section.


    • Carry out performance appraisal, coaching and mentoring staff;
    • Participate in planning and budgeting for the department.


    Academic Qualifications

    • Bachelor’s degree in nursing, business or other related fields
    • Registered nurse or clinical Medicine

    Professional Qualifications

    • Kenya Registered Nursing (KRN) diploma
    • IIK/CII preferred


    • Minimum of four (5) years’ relevant experience

    Skills and Attributes

    • Excellent communication and presentation skills
    • Problem solving skills
    • Excellent interpersonal skills
    • Good analytical skills
    • Computer literate in MS Office and other office applications
    • Understanding of the working environment /competitors
    • Technical competence in insurance
    • Basic knowledge of regulations by AKI and IRA

    Method of Application

    Interested and qualified? Go to CIC Insurance on to apply

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