Corporate & Claims Insurance Officer at Emerge Egress Consulting

Role Objective

• A hospital in Nairobi is seeking to hire a competent individual who is conversant with the smart system and ability to handle claims in the medical field effectively.

Core Duties and Responsibilities

• Responsible for analyzing, vetting and processing insurance claims to the satisfaction of clients in accordance with policy terms and conditions .
• Ensuring that claims made on insurance policies are dealt with promptly and efficiently.
• Appointment scheduling, managing schedules for doctors, specialists, and other healthcare providers. 
• Booking and coordinating patient appointments, rescheduling as needed, and 
• Ensuring efficient use of clinical resources, performing clerical duties such as fax, copying documents, filing etc and efficient operations.
• Maintaining accurate and confidential patient records in compliance with healthcare regulations. 
• Handle. Complaints and problem solving for various arising issues.
• Managed high volume phones and various forms of correspondences efficiently.
• Updating patient information and  hospital databases effectively.
• Billing and insurance coordination, assisting with patient billing processes, verifying insurance coverage, and handling billing inquiries. 
• Processing accurate documentation and requirements for reimbursement with the relevant parties.
• Manning front desk reception welcoming visitors, patients and other stakeholders and providing the necessary assistance.
• Responding to phone calls, emails, and other social media correspondence as required.
• Generating receipts and invoices and any other documents as needed.
• Providing general administrative support to hospital staff and departments.
• Any other duties assigned from time to time.

Job Specifications and Qualifications

• At least a Diploma in Business Administration, Communication, or elated field
• At least 2 years’ relevant work experience.
• Proficiency in MS Office Suite & CRM tools.
• Must possess not less than 2yrs experience working with SMART systems that handle health insurance companies.

Key Competencies

• Great communication skills 
• Patience
• Empathetic Skills.
• Customer Relationship Skills
• Problem Solving Skills