Vacancies at Old Mutual Kenya

This role facilitates and assists with delivery, design, development and assessment of learning interventions. The incumbent is individually accountable for achieving results through own efforts.

 KEY TASKS AND RESPONSIBILITIES

• Facilitates Learning interventions.
• Assists with the design and development of learning interventions.
• Customizes and/or updates existing learning material based on business needs.
• Reports on the strengths and shortcomings of the learning events.
• Improves learning Interventions when and if required.
• Facilitates formal, informal, standardized and customized learning interventions.
• Conducts knowledge/skills assessment for each learning intervention, including formative and summative assessments.
• Ensures all related learning data is captured.
• Assists with training needs analysis for specified area.
• Obtains quality approval for learning material prior to formal implementation.
• Facilitates compliance for sales teams and coordinates with Human Capital and legal execution of task

SKILLS ,KNOWLEDGE & COMPETENCIES

• Decision Making,
• Continuous Renewal,
• Client Focus,
• Initiating Action,
• Information Monitoring,
• Gaining Commitment
• Technical Knowledge,
• At least 2 years' experience

QUALIFICATIONS & EXPERIENCE

• Degree in Education /HR/Business related
• FMLI /Diploma in insurance
• Certified Professional Trainers -IHRM
• Sales experience will be an added advantage

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Job Description

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.