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MUA Kenya has inherited its rich history from one of the oldest insurance companies in East Africa - Phoenix Assurance Company Ltd. The company’s roots can be traced back to 1781, with the name “Phoenix” being adopted in 1812. Following the acquisition of Saham Kenya in July 2020, the two entities completed a comprehensive integration proce...
Applications are invited from appropriately qualified candidates for the position of Assistant Care Manager in the Medical Department. The position will be based in Meru.
Position Summary:
The successful candidate will be responsible for supervision of the claims process, provider customer care management as well as coordination of care management to ensure the medical department achieves the desired goals and objectives in line with the organization’s strategy.
Key Deliverables:
- Supervision and Coordination of care management
- Guiding Claims staff, upon request on difficult non-routine claim/client/broker/provider queries
- Interact with clients, brokers and clinicians as needed, to resolve problems within policy.
- Check and confirm membership validity and benefits (from the scheme benefits file)
- Vet and confirm validity of the service given by the service provider in relation to the benefits covered, treatment given, adherence to provider panel rules and cost of treatment
- Coordinate and supervise obtaining of additional required information on claims from providers, brokers or clients by team leaders
- Liaising with our underwriting section on scope of cover for various schemes
- Advice management on any peculiarities noted in the claims from group providers
- Assist in conducting provider audits wherever necessary.
- Client presentations and member education on wise utilization & risk management
- Address customer satisfaction issues promptly in accordance with the corporate strategy
- Manage the 24-hour emergency helpline
- Ensure claims position for the team is up to date
- Preparations of Monthly and weekly Care Management report; reimbursement claim status reports as well as admission reports
- Handling non routine queries from Brokers, providers and clients, Medical service provider
Requirements:
Applicant should have:
Ø Degree in Medicine with at least 2 years of practice
Ø A registered nurse with 5 years of practice
Ø Basic understanding of the concepts of insurance; Good Numerical skills
How to Apply:
If you are up to the challenge & fit the required profile, please apply highlighting your qualification, experience and career aspirations match the requirement for this position.
Application should be sent latest 12th August 2022 clearly indicating the position you are applying for on the Subject to: ke-vacancies@mua.co.ke . Only short-listed candidates will be contacted.
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Applications are invited from appropriately qualified candidates for the position of Deputy Head of Medical in the Medical Department.
Position Summary:
The successful candidate will be responsible for provider management by reconciling accounts with medical service providers and advising them on valid members and facilitates closure of the medical accounts to maintain the company’s credit worthiness. Excess and Fund Management, reporting and ensuring compliance
Key Deliverables:
- Reconciling accounts (claims received versus payments) to 100% within 3 months after the end of the contract year.
- Facilitating annual provider accounts sign off and recording keeping of the same
- Negotiate for discounts from providers
- Maintaining the system updates for; discounts, claims write offs, new providers additions
- Set up and maintain criteria of appointment and maintenance of new providers
- Ensure resolution of membership queries that affect reconciliations
- Assisting in conducting provider audits and quality assurance wherever necessary
- Obtaining additional required information on claims from providers, brokers or clients as part of debt management and reconciliation
- Following up on provider payments to ensure they are made on time
- Ensure effective dispatch of cheques and payments to the service providers and members across the country.
- Advising management on any peculiarities noted in the claims from group providers
- Facilitating the return of claims inadequately documented, claims for which members are not covered after verifying with the underwriter, non-payable claims and inadmissible bills.
- Manage medical excesses and collection to ensure minimal liability to the company
- Provide monthly updates on excess management
- Ensure effective system set up and management of third-party funds
- Assisting the credit control team in conducting reconciliation on Third party scheme accounts to ensure balances are accurate.
- Ensuring that management of Third-Party schemes is done ensuring that they are sufficiently funded to allow for services to be provided to clients.
- Follow up on collection, receipting and record keeping on Third party schemes.
- Reporting and analysis of the financial aspect of the medical business
- Assist the Head of Medical in overseeing the operations of the medical department to ensure effective running of the department
- Ensure regulatory reports are submitted.
- Staff management and monitoring on issues of leave, appraisals, training and day to day work duties.
Requirements:
Applicant should have:
- Bachelor of Commerce
- Qualification or progress towards achievement of CPA K certification
- At least 4 years’ experience in the insurance sector
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Applications are invited from appropriately qualified candidates for the position of Underwriter in the Underwriting Department.
Position Summary:
The successful candidate will be responsible for evaluating, pricing and prescribing the terms to apply on risk proposals so as to deliver the desired loss ratio and profitability. To update underwriting information into the system and generate debits, endorsements and Policy documents.
Key Deliverables:
- Risk assessment in line with the set underwriting guidelines
- Issuance of certificates upon receipt of request from clients in line with the credit control policy
- Ensure all the premiums are correctly debited to reflect in the months production
- Following up and reporting on motor certificates declarations
- Prepare and process debit notes, cover notes and policy documents
- Process renewals and endorsements
- Reconciliation of underwriting issues
- Process and dispatch of renewal notices 2 months prior to policies’ expiry period
- Following up on motor valuation reports before issuance of annual cover
- Respond to customer and intermediaries’ enquiries through emails, phone calls, within the shortest turnaround time.
- Generate and share quotations with prospective clients in a quest to acquire more business
- Prepare and dispatch debit/ credit notes, account reconciliation statements
- Process and dispatch of AA membership cards to clients and intermediaries
- Cancellation of policies due to non-payment of premiums.
- Ensure proper filing of client information for easy retrieval of documentation when required
- Support the business development team in marketing and business acquisition.
- Prepare the Underwriting reports within the set timelines
- Recommending survey for properties
Requirements:
Applicant should have:
- Bachelor’s Degree in Business or in a related field
- Up to Two (2) years’ relevant work experience
- Professional Qualifications
- Progress towards CII or IIK (Required)
- Basic knowledge of regulatory requirements and processes by AKI and IRA
Skills and Attributes
- Excellent communication and presentation skills
- Problem solving skills
- Excellent interpersonal skills
- Good negotiation skills
- Good analytical skills