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  • Posted: Dec 6, 2024
    Deadline: Dec 12, 2024
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    Old Mutual Kenya is based in Nairobi and is part of a larger group that offers solutions in long-term savings, asset management and investment. We offer solutions to individuals and corporates underpinned by our core values which are: Respect, Integrity, Accountability and Pushing beyond boundaries.
    Read more about this company

     

    Senior Relationship Officer SME

    Responsibilities

    Data Collection and Analysis

    • Collate and analyze data using preset tools, methods, and formats. Involves working independently.

    Information and Business Advice

    • Resolve queries from internal or external customers or suppliers by providing information on complex processes and the related policies, referring issues to others where necessary for interpretation of policy.

    Document Preparation

    • Prepare moderately complex documents using a variety of applications for technology devices, such as standard office software. Also responsible for gathering and summarizing data for reports.

    Insights and Reporting

    • Extract and combine data to generate standard reports.

    Customer Relationship Management / Account Management

    • Make calls (by telephone or in person) to allocated customers to maintain and strengthen existing relationships. Act as a first point of contact for resolving customer queries and complaints.

    Financial Advice

    • Conduct comprehensive financial planning and advice services for more complex client situations.

    Sales

    • Deliver mostly routine sales support services.

    Operational Compliance

    • Develop knowledge and understanding of the organization's policies and procedures and of relevant regulatory codes and codes of conduct to ensure own work adheres to those standards. Obtain authorization from a supervisor or manager for any exceptions from mandatory procedure.

    Personal Capability Building

    • Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching. Develop and maintain an understanding of relevant technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media.

    go to method of application »

    Medical Claims Vetter

    Skills

    • Medical Claims Vetting
    • clinical experience

    Education

    • Bachelor’s degree in any medical related fields, Diploma in Nursing /Clinical Medicine or any medical related field
    • To process medical claims with a focus on cost control and management of member benefits through vetting and coding inpatient and outpatient bills and capturing in the company medical business operating system(s).
    • Verify, audit and Vet medical claims for payment for both outpatient and inpatient claims as per the claim’s manual/Standard operating procedure.
    • Adhere to customer service charter manual to ensure compliance to agreed turnaround times
    • Prompt reporting of any identified risks during claims processing for mitigation.
    • Monitor, prevent and control medical claims fraud/wastages during claims processing.
    • Use of data analytics to review cost and quality of service at medical service providers.
    • Hold regular business meetings with service providers to ensure compliance on systems such smart card system and agreed tariffs.
    • Evaluate preliminary claim information and revert to broker or insured for more information where necessary to ensure that the correct information is documented for ease in processing of member reimbursement claim
    • Respond to client enquiries within 24hrs of enquiry.
    • Communicate and liaise with medical service providers on resolution of disputed claims.
    • Any other duties assigned by management.

    Method of Application

    Use the link(s) below to apply on company website.

     

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