Clinical Officer (Claim Management) at Asterisk Solutions

On Friday, October 9th, 2015
 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.
How to Apply

Interested and suitable qualified candidates should forward their applications and detailed CV indicating working experience, current and expected salary to [email protected] with the JOB TITLE as the subject by 10th Oct 2015.

Posted in Health Care
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