Our Client is currently recruiting a Clinical Officer to work as a Claims officer
Job Description:
- Clinical officer has to be well equipped with the latest trends and technologies used.
- Expert in analyzing actual and fake treatments claims.
- Expert in drafting the process in and out.
- Smart in tackling varies types of clients.
- Clinical officer has to be the one and only stop for whole process execution for clients.
- Clinical officer is incumbent for the billing, filing, updating and processing of medical claims related to patient diagnoses, treatments and medications.
- Submit claims to insurance.
- Process Company’s response to claims.
- Regular liaison with insurers, loss adjusters/appointed experts.
- Utilizing new Claims repository.
- Submit billing statements to patients.
- Perform data entry and processing.
- Formulate objectives and processes.
- Monitoring inventory records.
- Supervising the educational material provided to patients by clinical officer.
- Evaluating the Preparation and delivery of claims presentations by clinical officer.
- Provide cover for colleagues in their absence, ensuring that the handling of their claims is kept up to date.
- Any other duties as may be assigned.
- Carrying out specialized procedures under the guidance of a senior Medical Personnel.
- Liaising with other healthcare personnel for efficient delivery of patient care.
- Receiving, examining, and scanning patients in the filter clinics.
- Treating or referring them to respective specialists.
Key Accountabilities (What you are measured on)
- Maintain claims files (paper and repository), ensuring they are up to date.
- Maintain diaries/claims tracking systems.
- Maintain accurate record of claim advices, reserve changes and payments.
- Ensure payment of claims is made promptly and efficiently.
- Ensure client satisfaction.
- Maintain strong relationships with clients and claims underwriters.
- Ensure claims team and client teams are kept apprised of significant claim development.
Minimum Qualifications
- Kenya Certificate of Secondary Education (KCSE) with a mean grade of C or its equivalent qualification.
- Higher Diploma/Diploma in Clinical Medicine.
- Registration Certificate from the Clinical Officer Council.
If you feel you fit the above role, please send your CV only quoting the job title on the email subject to jobs@alternatedoors.co.ke
N.B: We do not charge any fee for receiving your CV in our database nor for interviewing.
Only candidates short-listed for interview will be contacted
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