-
Claims Assistant at
4 days ago
Incourage Nairobi, Kenya Full timeSimplifying insurance access and distribution for insurance agencies. · About the Claims Assistant Role · This role involves filing and processing claims into the company's system, gathering and organizing files for audits and corresponding with insured individuals about obtainin ...
-
Claims Assistant
4 days ago
Incourage Nairobi, Kenya Full timeABOUT THE COMPANY · To encourage and increase the players in the insurance industry by building a No.1 platform where anyone can easily purchase and sell insurance products in Africa. · JOB SUMMARY · This role involves filing and processing claims into the company's system, gath ...
-
Assistant Claims Officer at
4 days ago
Britam Nairobi, Kenya Full timeBritam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi. · Job Purpose: · To ...
-
Claims Assistant – General Business at
1 week ago
CIC Insurance Nairobi, Kenya Full timeCIC Insurance Group Limited, commonly referred to as CIC Group, is an insurance and investment group that operates mainly in Kenya, Uganda, South Sudan and Malawi · PURPOSE: · Responsible for effectively handling claims and settling them within stipulated timelines. · PRIMARY RES ...
-
Claims Intern
3 days ago
Absa Group Ltd Nairobi, Kenya Full timeJOB SUMMARY · Job DescriptionEnsure that the allocated claims processes are performed within the time frames as agreed with clients, brokers, and other departments to ensure service delivery.Ensure that service providers fee notes, invoices and Discharge vouchers are settled with ...
-
Assistant Reinsurance Manager at
1 week ago
CIC Insurance Nairobi, Kenya Full timeCIC Insurance Group Limited, commonly referred to as CIC Group, is an insurance and investment group that operates mainly in Kenya, Uganda, South Sudan and Malawi · PURPOSE: · To achieve reinsurance business growth and development to generate revenues to support the company's gro ...
-
Kingdom Bank Limited Nairobi, Kenya Full timeKingdom Bank is a subsidiary of the Co-operative Bank of Kenya, following its acquisition of Kingdom Bank in August 2020. We are now part of a Group with over Kes. 457 Billion total assets and Kes 20.7 Billion profit before tax as at 31 December 2019. · Reports to: Principal Offi ...
-
Cigna Nairobi, Kenya Full timeCigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. · About the job · You are responsible for the client communication for designated account relationships and Contracts. · You are required to ...
-
Customer Service Representative
5 days ago
Cigna Nairobi, Kenya Full timeCigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the world · About the job · You are responsible f ...
-
Cigna Nairobi, Kenya Full timeABOUT THE COMPANY · Cigna is a global health service company with 95 million customers around the world and more than 40,000 employees worldwide. As your partner in health, we're available for our customers 24/7 with an expansive network built to help them meet their health goals ...
-
Cigna Nairobi, Kenya Full timeCigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the world. · About the job · You are responsible ...
-
Customer Service Representative
6 days ago
Cigna Nairobi, Kenya Full timeABOUT THE COMPANY · Cigna is a global health service company with 95 million customers around the world and more than 40,000 employees worldwide. As your partner in health, we're available for our customers 24/7 with an expansive network built to help them meet their health goals ...
-
Junior Clerk
4 days ago
Bliss Healthcare Nairobi, Kenya Full timeABOUT THE COMPANY · Bliss Healthcare is a leading integrated healthcare network in Kenya providing complete outpatient services. We take pride in providing efficient, accessible, quality and affordable healthcare services, across 37 counties in Kenya's Urban and Rural Communities ...
-
The Cigna Group Nairobi, Kenya OTHERThe job profile for this position is Customer Service Representative, which is a Band 1 Professional Career Track Role.Excited to grow your career? · We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting ...
-
Customer Service Representative
6 hours ago
The Cigna Group Nairobi, Kenya OTHERThe job profile for this position is Customer Service Representative, which is a Band 1 Professional Career Track Role.Excited to grow your career? · We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting ...
-
Bancassurance Officers at
6 days ago
Equity Bank Kenya Nairobi, Kenya Full timeEquity Bank Limited (The "Bank") is incorporated, registered under the Kenyan Companies Act Cap 486 and domiciled in Kenya. The address of the Bank's registered office is 9th Floor, Equity Centre, P.O. Box Nairob · Job Purpose: · This role is responsible for supporting the branc ...
-
Legal Manager
4 days ago
Absa Bank Limited Nairobi, Kenya Full timeAbsa Bank Limited (Absa) is a wholly owned subsidiary of Barclays Africa Group Limited. Absa offers personal and business banking, credit cards, corporate and investment banking, wealth and investment management as well as bancassurance. · Job Summary · The Legal Manager will ser ...
-
Legal Clerk at
1 week ago
Kenindia Assurance Company Limited Nairobi, Kenya Full timeKenindia Insurance Ltd, was established as merger of Indian Insurance Companies operating in Kenya to form a vibrant joint venture with moral and financial support from leading local business elite on 6th December 1978. · Main Purpose of the Job - (Job Summary): · Office administ ...
-
Legal Assistant at
18 hours ago
UN-Habitat Nairobi, Kenya Full timeThe United Nations Human Settlements Programme, UN-Habitat, is the UN agency for human settlements. It is mandated by the UN General Assembly to promote socially and environmentally sustainable towns and cities with the goal of providing adequate shelter for all · ABOUT JOB · The ...
-
Regional Relationship Manager
6 days ago
Equity Bank Kenya Nairobi, Kenya Full timeEquity Bank Limited (The "Bank") is incorporated, registered under the Kenyan Companies Act Cap 486 and domiciled in Kenya. The address of the Bank's registered office is 9th Floor, Equity Centre, P.O. Box Nairob · Job Purpose: · This role is responsible for supporting the branc ...
EMC Medical Claims Assistant at - Nairobi, Kenya - Britam
Description
Britam is a leading diversified financial services group, listed on the Nairobi Securities Exchange.The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi.
Job Purpose:
Controlling and Managing policies through case management to ensure quality and cost effective care., client service, processing and payment of EMC claims.
Key responsibilities:
Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration).
Interact with clients and service providers to ensure that the care is given within policy guidelines.
Review medical reports and claims for compliance with set guidelines.
Liaise with underwriters on scope of cover for the various schemes.
Ensure that medical scheme members are attended to round the clock with support from 24 hour call centre.
Poly-Pharmacy – discourage poly-pharmacy by diligent challenging of prescriptions and suggesting better alternatives.
Generic substitution – Encourage use of generics where indicated as a method of reducing the organizations pharmaceutical expenditure.
Review documents and pertinent requirements regarding claims from providers and clients.
Ensure that the claim made by the claimant is complete in form and complies with the documentary requirements of an insurance claim.
Management of relationships with clients, intermediaries and service providers.Verification and audit of outpatient and inpatient claims to ensure compliance and mitigate risk.
Advice claimants regarding basic matters about their insurance coverage in relation to the insurance claim.
Respond to both internal and external claims inquiries concerning claims process, service providers, and the filing/completion of proper forms.
Record all claims transactions.Prepare claims registers for claims meetings and update the various claims reports.
Track and follow up on receipt of necessary documents.
Delegated Authority:
As per the approved Delegated Authority Matrix.
Knowledge, experience and qualifications required:
Professional Nursing qualification KRCHN licensed by Nursing council of Kenya.
At least one year experience in case management and claims processing
EMC Medical Claims Assistant at professionals in Nairobi
-
charles metumi
Nursing officer
-
Harriet Moraa
Registered Clinical Officer
-
Charity Lorretta
Custmer service agent
-
Alfred Otieno
Banking and finance.
-
Lucy Nganga
I'm a medical assistant by professional
-
Kiluku Lilian
Health records assistant