Vacancies at CIC Insurance

PURPOSE:

Responsible for receiving and processing claims for provider payment.

PRIMARY RESPONSIBILITIES:

• Ensure that all claims received are well stamped and keyed in for future reference.
• Dispatch received invoices, mails and claim books to respective sections
• Dispatch claim forms and other relevant documents to providers
• Confirm that smart claims have been billed correctly
• Prepare valid claims for scanning.
• Upload, attach and index relevant documents to Document Management System
• Facilitate discarding of scanned claim documents as per the approved disposal procedure.
• Registration of medical claims in the system
• Follow up on registration and reconciliation of provider statements to ensure closure.
• Follow through to ensure all claims with issues at registration level have been addressed or escalated to the supervisor for action
• Respond to walk in customer enquiries
• Attend to customer and service providers’ queries and complaints promptly and professionally

Academic and Professional Requirements

Education

• Bachelor’s Degree in a relevant field,E
• Computer literate in MS Office and other office applications
• Relevant technical training certificate / part qualification in relevant

Experience Required: 

• One year relevant experience 

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PURPOSE:

To assess and prudently underwrite General Business in commercially sound terms and to ensure that all underwriting and documentation duties in the section operate effectively and efficiently.

PRIMARY RESPONSIBILITIES:

• Maintain a tender register and share monthly report on tender achievement
• Prepare tender and prequalification documentation as per guidelines and within the TATs
• Attend to online tenders and prequalification documentation as per guidelines and within the TATs
• Requisition and good maintenance of departmental stationery and equipment
• Ensure that CIC renewable tender documents remain current
• Processing of departmental payments such as tender purchases
• Provide monthly intelligence reports on prevailing rates
• Service to all customers within a reasonable time

 Academic and Professional Requirements

Education

• Diploma in a business-related field. 
• Computer literate in MS Office and other office applications 

Experience Required:

• Background in tender documentation will be an added advantage    2

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PURPOSE:

Responsible for care facilitation/cost containment and call centre reachability.

PRIMARY RESPONSIBILITIES:

• Issuance of approval to insured members seeking both inpatient and outpatient care as per policy guidelines.
• Monitor cost, average length of stay on inpatient cases.
• Issue guidance on Pre-authorized optical, dental and scheduled procedures
• Conduct Hospital visits whenever the insured members are hospitalized
• Respond to stakeholder inquiries on cases involving medical care management.
• Receive and respond to Medical emergency lines and ensure 24-hour coverage
• Negotiate for discounts from doctors and hospitals on specific cases and procedures from time to time
• Facilitate referrals and medical evacuations when need be.
• Monitor benefits utilization and share timely updates to the stakeholders.
• Prepare and share timely reports as may be guided.

Academic and Professional Requirements

Education

• Diploma in Nursing or Clinical Medicine  
• Computer literate in MS Office and other office applications

Experience Required:

• Relevant experience in Care Management, medical claims and call centre    2