Benefit Verifier at ADEC Kenya Services EPZ Limited (ADEC Kenya)

Join our dynamic team as a benefits verifier, where you'll play a crucial role in providing customer support and delivering quality work based on company standards. This role is essential in ensuring the accuracy and completeness of medical billing information, adhering to guidelines, and addressing client inquiries effectively!
Key Responsibilities:

• Update medical billing information to ensure accuracy.
• Contact clients for missing data elements or information on claims.
• Talks to customers to gather details, probing for necessary information (i.e. specific concerns, account details, name etc.).
• Verifies if information relayed is accurate and complete to properly address clients' concerns and queries (i.e. name, addresses, etc.).
• Review the explanation of benefits to ensure the correctness of the given information.
• Utilizes various references to validate the accuracy of inputted information in the system. • Prepares and monitors the thorough accounting of status updates/process particulars and documents the transactions.
• Analyze and classify patient/claim information before encoding.
• Gather and verify details from customers to address concerns through inbound and outbound calls.
• Ensure correctness of explanation of benefits and validate information using various references. • Actively listen and respond to customers, providing quality service in every call.
• Regularly check updates and process flows to ensure compliance with client specifications.

Requirements:

• At least 1 year of experience as a voice call center agent/Customer Service Representative handling inbound and outbound calls.
• Minimum 1+ years of outstanding phone Communication skills (Inbound & Outbound) experienced in Call Centre role in English.
• Strong knowledge of healthcare insurance terminologies. 
• Familiarity with navigating insurance portals like Availity.
• Excellent attention to detail, especially with names and numbers.
• Basic technical proficiency and problem-solving skills.
• Strong working knowledge of Microsoft Office tools.
• Flexible to accommodate different shift jobs including night shifts and must be staying or ready to relocate to Kitengela, Athi River, or Mlolongo