Vacancies at Stratostaff

Profile Introduction            

Our client, a leading financial and health insurance company seeks to bring on board an Underwriting Analyst. The role will be responsible for assisting in the risk. Management through assessing the eligibility of applicants to obtain medical cover, Scheme performance analysis, proposal of appropriate renewal terms and scheme Administration for those already on medical cover within the set standards of service.

Key Areas of Responsibility

• Keep detailed and accurate records of health business policies underwritten and decisions made (both in med care 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 med ware 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 skills.
• 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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Profile Introduction            

Our client, a leading financial and health insurance company seeks to bring on board an Claims Analyst. The role will be responsible for processing medical claims with a focus on accuracy, cost containment, risk management and customer excellence.

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.