Medical Claims Analyst at Old Mutual Kenya

Job Description

To assist in processing of medical claims with a focus on cost control and management of member benefits through linking and coding of inpatient and outpatient bills and capturing in the company medical business operating system(s).

• Capturing of claims as per set rules/guidelines and validate a claim against policy / scheme / guidelines, agreed etc.
• Organizing trainings on document uploads in liaison with key partners and ensuring compliance with the corporate document management policy
• Clean up of the medical claims electronic data management system to ensure an efficient document management system.
• Proactive management of member benefits and reporting of any unusual trends as per the agreed SLA with suppliers and partners.
• Offer Resolution of any missing information required to fully capture a claim by reaching out to the finance payables team.

Education

• Qualification- Bachelor’s degree in any medical related fields, Insurance field or Business field.