Medical Claims Analyst

An established company is recruiting for the following position. JOB PURPOSE - Analyzing of medical claims and to ensure the smooth flow of work in line with the departmental requirements to achieve overall business objectives. PRINCIPAL ACCOUNTABILITIES - Ensuring daily recording of incoming medical bills. - Receiving claims and checking corresponding policies in line with the claim. - Reconciliation of Medical service providers accounts. - Registration of claims and reserving adequate estimates. - Ensuring the ailment is covered under the policy. - Ensuring the treatment and the drugs dispensed are in line. - Ensuring the with-holding Tax by Doctors’ is complied with before cheque dispatch. - Ensuring the appointment of investigators for authenticity of questionable claims. - Ensuring the facility is registered within the medical practitioners and dentists board. - Preparing claim notes for vetting by the medical personal and approval/comments by the HOD. - Ensuring dispatch of discharge voucher to the client and communicating by writing on the liability. - Ensuring claims are settled within approved company guidelines - Ensuring proper dispatch of settlement cheques. - Ensuring that the files are sent back to the filling room. - Reconciling of claim statements from stakeholders for correct position of their accounts - Preparing remittances for any Medical claims cheques before dispatch. - Ensuring proper records of outgoing settlement cheques to various stakeholders. - Ensuring service providers meet agreed service timeline. - Ensuring customers service to both internal and external - And any other duties assigned MINIMUM QUALIFICATIONS - KNOWLEDGE AND EXPERIENCE - Undergraduate Degree in any Related Field - AIIK - CPA - At least 2 years of relevant experience