Medical Claims Analyst

The Position:

Reporting to the Healthcare Administrator-Bancassurance, the role holder will be responsible for day to day engagement with medical providers to ensure quality healthcare provision to members of medical schemes as well as analysis and processing of medical bills submitted for settlement.

Key Responsibilities:

  • Vetting and analyzing medical claims as per scope of cover whilst ensuring strict adherence to set guidelines and TAT
  • Preparation of members’ reimbursement claims and payment of the credit medical providers
  • Preparation of utilization reports and other reports as required by member / client
  • 24 hour on-call services in management of medical scheme issues and emergency evacuations for medical scheme members country wide
  • Maintenance of the filing of the medical schemes data/ payment vouchers to ensure proper record keeping
  • Reconciliation of medical providers’ bills & accounts on an ongoing basis or on demand including visits to providers to sort out contentious bills/ issues
  • Updating staff medical reimbursements and ensuring all utilizations are captured on a timely basis
  • Professional assistance to all the staff members/dependants with chronic ailments and facilitating follow up in specialists’ clinics

Candidate’s Qualifications, Knowledge and Experience:

  • Diploma in Kenya Registered Community Health Nursing nursing/ clinical medicine/ pharmacy and/ or in any medical related background i.e. Pharmacy, medical laboratory or clinical medicine.
  • At least 3 years’ experience in a busy health Insurance environment with Claims Vetting & Care management background.
  • Computer literate and familiar with high processing speed using standard office software applications.
  • Training in Basic and Advance Life Support will be an added advantage.

Desired Skills and Ability:

  • Mature, team player with strong interpersonal and persuasive skills
  • Good planning and organization skills with the ability to deliver effectively under strict deadlines
  • Excellent Listening and Communication skills
  • Accuracy and attention to detail
  • Ability to develop working relationships with a wide range of internal and external partners
  • Maintaining strict confidentiality and integrity of all information he/she comes across in the execution of their duties

The above positions are demanding roles for which the Bank will provide a competitive package for the successful candidate. If you believe you can clearly demonstrate your abilities to meet the criteria given above, please submit your application with a detailed CV, stating your current position, remuneration level, e-mail address and telephone contacts quoting the job title/reference in the subject field to recruitment@kcb.co.ke.

To be considered your application must be received by Friday, 26th May, 2017

Only short listed candidates will be contacted.

NB: In the event that you are successful, we will require that you provide us with the following documents:

  • National I.D.
  • KRA Pin Card
  • Birth Certificate of self
  • Passport Photo (White Background)
  • NSSF Card
  • NHIF Card
  • Certificate of Good Conduct (less than 5 Months old)
  • Academic and Professional certificates, including official transcripts
  • Certificates of Service as applicable

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