Clinical Officer (Claim Management) at Asterisk Solutions
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 hr@asteriskkenya.com with the JOB TITLE as the subject by 10th Oct 2015.
