Summary
Date Posted: Saturday, March 19, 2022 , Base Salary: Not Disclosed

JOB DETAILS:
The person is expected to identify claims that do not meet the criteria of APA policy, procedures and medical norms. The person will be responsible for ensuring the quality and accuracy of claims processed while maintaining the TAT and production levels necessary for provider and client satisfaction

KEY PRIMARY RESPONSIBILITIES
• Coordination and adjudication of all claims received
• Monitoring, preventing and highlighting medical claims fraud through regular claim audits and reporting
• Follow up with providers for bills, discrepancies in bills and other information that is holding up processing
• Answering client enquiries on claims through e-mail, phone or directly
• Filing of Claims processed
• Confirming number and amount of invoices received then batching in readiness for processing
• Maintaining feedback with the internal and external clients on claims and membership issue
• Scanning and indexing of claim documents
• Batching and separating documents in readiness for scanning and processing
• Filing and archiving documents for easy retrieval
• Receiving and acknowledging claims documents

ACADEMIC QUALIFICATIONS
• Relevant University Degree

JOB SKILLS AND REQUIREMENTS
• Integrity and honesty
• Able to manage tight deadlines
• Pay attention to detail and to following processes
• Excellent written and spoken communication skills
• Proficient in Microsoft Office
• Willingness to work weekends when required

PROFESSIONAL QUALIFICATIONS
• Diploma/Certificate in insurance is an added advantage
EXPERIENCE
• Relevant experience in Health claim processing in a busy environment

Job Experience: No Requirements

Work Hours: 8

Level of Education: Associate Degree

Job application procedure
Send mail to recruitment@apollo.co.ke indicating the position as subject of the mail

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