Fresh Jobs at CIC Insurance

About the Role

CIC Africa Insurance (SS) Ltd, a subsidiary of CIC Insurance Group is looking to recruit highly skilled individuals to fill the position of Medical Claims Analyst to be based in the Head Office in Kenya. Reporting to the Medical Supervisor – Claims & Care Service Management, the role holder will be responsible vetting both in/ outpatient medical claims for payment.

Key Responsibilities

• Vet in/outpatient medical bills/invoices and refer any suspicious claims to the supervisor; 
• Batch outpatient invoices on the system and adjust amount payable as per the vetting findings; 
• Check and reject incomplete invoices and return with supporting documents to service providers. 
• Negotiate, adjust and update service providers on their costs and accounts status;  
• Reconcile statements of accounts for service providers; advising accounts and service providers on unpaid/underpaid bills; 
• Review claims reserves on a continuous basis in view of new developments;  
• Attend to customer queries and complaints promptly and professionally and 
• Recommend risk improvement measures to the underwriter to take appropriate action. 

Who We’re Looking For

Essential Knowledge/Skills and Experience Required:

• Bachelor’s degree in a related field or a Diploma in Nursing / Diploma in Clinical Medicine. 
• Minimum of 3 years of relevant experience. 
• Registered Nursing, Diploma – Required  
• Excellent communication and presentation skills 
• Problem solving skills 
• Excellent interpersonal skills  
• Good negotiation skills 
• Good analytical skills 
• Computer literate in MS Office and other office applications 
• Understanding of the working environment /competitors 
• Technical competence in insurance  
• Basic knowledge of regulations by the regulators 

go to method of application »

About the Role

To provide general customer service in respect to medical business customers.

Key Responsibilities

• Receive and respond to Medical Emergency lines and ensure 24-hour coverage of the Call Centre.
• Handle phone calls and visitors, as well as resolve customers’ communication through electronic and physical channels.
• Issuance of both in and outpatient approvals for admissible requests for insured members.
• Communication to stakeholders on management of cases and financial liability through reports.
• Provide input for the customer service reports.
• Share daily/weekly and monthly reports as may be required from time to time.
• Participate in cost management initiatives/strategies that have been put in place by the business.
• Handle customer service issues and queries in a timely manner.
• Escalate Customer queries to the relevant job role if necessary.
• Maintain professional ambience within the office premises.

Who We’re Looking For

Essential Knowledge/Skills and Experience Required:

• Diploma in Clinical Medicine/Nursing (KRCHN)
• Customer Experience training will be an added advantage.
• Minimum of 3 years of experience in busy health environment with 1 year of experience in Medical call centre management unit.