Care Analyst at Liberty Life

Job Summary

The role holder will be responsible for ensuring that Heritage customers receive affordable, accessible, cost effective and high-quality healthcare services.

Key Responsibilities

• Membership benefit utilization management
• Verification and assessment of pre-authorization requests and claims
• Hospitalizations management and cost optimization
• Review and pre-screening of received claims
• Customer service-handling calls, addressing client queries on all touch points
• Maintain proper departmental standards
• Process/adjudicate claims
• Case management through hospital visits

Qualifications

• Bachelor’s degree in Nursing/Diploma in Nursing or Clinical Medicine

Experience

• At least 1 year technical knowledge in medical insurance or hospital setting.

Competencies

• Understanding of health insurance operations and concepts
• Knowledge of medical claims processes and procedures
• Stakeholder management
• Customer service