Vacancies at Stratostaff

Key Areas of Responsibility

• Keep detailed and accurate records of health business policies underwritten and decisions made (both in medcare and in physical files).
• Assist in underwriting health insurance risks
• Carry out scheme performance analysist and propose appropriate renewal terms
• Participate in preparation of quotations within set standards
• Prepare policy documents, endorsements debits and credit notes
• Dispatch policy documents, new business and renewal debits and endorsements within the set time frames.
• Assist in renewal of policies in the system within the set time frame.
• Attend to correspondence and client queries (both written and by phone) within the set time frames.
• Attend to correspondence and client queries within set timelines
• Prepare reports as may be required from time to time.
• Debt management at business entry point and renewal in line with the credit policy.
• Implementation of policy suspension and policy cancellations
• Liaison with the other departmental and company functions to ensure smooth delivery of services to insured clients
• Implementation of TCF
• Provider liaison to ensure that all providers have updated scheme and membership records
• Reconciliation of smart applications and medware records to ensure data consistency.

Minimum Qualifications:

• Bachelor’s degree in insurance or business related discipline.
• Progress towards Diploma in Insurance (ACII, or AIIK), (at least three papers or equivalent).
• 2 years’ experience in insurance industry

Core Competencies

• Customer, market an competitor understanding
• Knowledge of insurance industry and concepts
• Knowledge of insurance regulatory requirements
• Knowledge of medical underwriting processes, procedures and concepts
• Negotiation skills
• Business management skills
• Excellent analytical skiils
• Excellent organizational and stakeholders management skills
• Result driven
• Adapting and responding to change
• Planning and organization
• Presenting and communicating information
• Persuading  and influencing
• Interpersonal skills
• Adherence to principles and values

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Key Areas of Responsibility

• Review, assess, authenticate and capture outpatient and inpatient claims as per the claims manual and within the set TATs
• Timely scanning, barcoding and batching of received claims
• Processing of reimbursements within the set TATs
• Conduct quality assurance process before batches are authorized for pay run
• Notify brokers and clients of pended and declined claims within set timelines
• Manage pended and declined claims
• Liaise with agents, brokers and service providers on matters arising on claims
• Ensure all claims documents are archived in the relevant systems
• Maintain claims production within set targets
• Generate daily health claims status report
• Storage of all correspondence in Medware system
• Monitoring and processing of NHIF enhanced benefits for cost containment
• Recording and monitoring of roaming and counter-guarantee claims.
• Customer service – address clients’ queries in form of telephone queries, letters, emails and walk –in clients.
• Maintain proper department standards, discipline and confidentiality regarding patients’ illness

Minimum Qualifications:

• Bachelor’s degree/ Diploma in medical, insurance or business-related discipline
• Progress towards Diploma in Insurance will be an added advantage.
• 1 years’ experience in medical claims management in insurance/hospital setting

Core Competencies

• Knowledge of insurance concepts
• Knowledge of medical claims processes and procures
• Knowledge of insurance regulatory requirements
• Stakeholder management
• Customer service
• Good Microsoft Excel skills and math aptitude
• Delivering results and meeting customer  expectations
• Interpersonal skills
• Planning and organizing
• Presenting and communicating information
• Persuading and influencing
• Supervisory skills
• Adhering to principles and values

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Key Areas of Responsibility

• Maintain constant contact with hospitals to ensure continuous well-being of all the stakeholders and handling of medical claims with efficiency and accuracy.
• Pre-authorise scheduled and non-scheduled admissions within the set guidelines.
• Liaise with the hospitals and doctors for prompt discharge plan of the admitted members.
• Assess and authenticate inpatient and outpatient medical claim documents.
• Ensure smooth discharge process and co-ordinate any necessary post-hospitalisation care.
• Prescreening and vetting of inpatient, outpatient and reimbursements claims to ensure adherence to agreed tariffs and clinical protocols, with clearly documented notes in case of decline and any discount offered by the providers.
• Conduct hospital visits and monitoring of inpatient bills.
• Daily monitoring of interim bills and appropriate interventions for high quality of care.
• Daily status reporting of the clinical status of the admitted members.
• Contact centre management, pre-authorization approvals on payments and responding to member and provider enquiries.
• Ensure timely notification to the stakeholder team of all the declined cases as per the policy guidelines.                                                                                                             
• Timely resolution of all the complaints raised by clients.                                           
• Responding to all clients and providers requests within 24 hours
• Ensure all counter guaranteed and roaming cases have official letters before approvals are done.
• Authorization of maternity bookings and wellness letters are issued within 24hrs.
• Monitoring client with chronic diseases by ensuring managed health care forms are completed by the doctors for proper follow up and management. 
• Health talks, wellness and check-ups management with providers and all stake holders
• Ensure inculcation of the TCF (Treating Customers Fairly) culture

Minimum Qualifications:

• Degree or Diploma in Medicine, Nursing, Clinical Officer, or Pharmacy
• 2 years’ clinical experience

Core Competencies

• Understanding of health insurance operations and concepts
• Knowledge of medical claims processes and procedures
• Stakeholder management
• Customer service
• Analytical skills
• Interpersonal skills

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Key Responsibilities:

• Responsible for ensuring the duties of their position are performed in a safe, efficient and effective manner.
• Performs Basic cutting and welding procedures
• Performs predictive maintenance procedures i.e. daily checklists, advice company on areas of improvement to maximize output and reduce breakdowns
• Ensures 98% plant availability mechanically
• Ensures that all work is undertaken in compliance with the operating procedures, legislation and the codes of practice
• Performs preventive /corrective maintenance to eliminate downtime
• Diagnoses causes of malfunction or failures, recommend modification /replacement of failed equipment’s and parts
• Install and /or replace new or reconditioned repair parts
• Fill and maintain job cards and work orders for maintenance task performed
• Test equipment for proper operation
• Record and track key KPIs &technical data such as energy consumption, water usage, spare parts inventory, MTBF, MTBW, MTTR.
• Handle any other duties assigned by the management from time to time
• Performs and ensures assigned duties are completed within set time frames
• Maintains, diagnoses and repairs a variety of equipment including: high pressure pumps, centrifugal pumps, conveyor systems, air compressors, electro mechanical equipment’s, hydraulic system, pneumatic systems, pressure equipment, generator

 MINIMUM REQUIREMENTS:                                                        

• Diploma in Mechanical Engineering / Mechatronic Engineering
• 5 years of experience in a similar role in a busy manufacturing company.
• Courses in basic Electrical Engineering, Mechatronics is an added advantage.
• Basic CAD and drafting skills.
• Solid and proven technical background
• A fast leaner and someone that takes initiative
• An active participant in a team or collaborative environment.
• Has strong organizational skills.