Medical Claims Analyst at Old Mutual Insurance Rwanda | Kigali :Deadline: 01-10-2024

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Role Title:

Medical Claims Analyst – 1 Post

Business Unit(s):

Rwanda

Business /Function:

Medical Claims Analyst

Location:

Rwanda-Kigali

Reports To:

Senior Claims Analyst

MDP Level:

Manager of Self

Role Size

L




JOB SUMMARY

To ensure prompt processing of medical claims.

PRINCIPAL ACCOUNTABILITIES.

  • Manage Claims Ratio as per target
  • Use claims tariff during claims payment and signing with providers
  • Prompt claims settlement as per agreement with providers
  • Reconcile service provider account and close issues arising
  • Enhance claims documentation for better adjudication
  • Pharmacy claims management
  • Smart claims monitoring
  • Major provider management
  • Contain Optical claims
  • Reduce drug cost through implementation of Pharmacy Book
  • Claims vetting and adjudication
  • Effective communication
  • Provider and customer Email management
  • Complaints resolution time
  • Management of reimbursement Claims
  • Compliance to Procedure Manuals
  • Ensure complete and efficient implementation of e-Oxygen and its integration with other systems.
  • Departmental meeting
  • Process reviews yearly
  • Individual Performance management
  • Report your duties monthly on time (on 5th of the month)
  • Any other task as assigned by your Line Manager

Qualifications and experience

  • University degree in health-related field
  • Basic Insurance qualification

Skills and competencies

  • Good communication and negotiating skills
  • Good attention to details and accuracy
  • Good analytical and monitoring skills
  • User IT skills in database management and office systems.
  • Good interpersonal skills
  • Thorough understanding of policy covers/wordings and their interpretation as pertaining to claims


Integrity and honesty

Please visit our careers page through: 

https://oldmutual.wd3.myworkdayjobs.com/en-US/Old_Mutual_Careers/details/Claims-Analyst_JR-58805?q=rwanda

Interested candidates are requested to submit their applications by 5.00 p.m. 1st October 2024.

Applicants must possess or be in the process of applying for a POLICE CLEARANCE CERTIFICATE as at the time of making an application.

ONLY short-listed candidates will be contacted.

 

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