Care Analyst - Liberty Life, Nairobi

This vacancy presents a chance to join a leading organization. Position Overview: The role holder will be responsible for ensuring that Heritage customers receive affordable, accessible, cost effective and high-quality healthcare services. Key Responsibilities:

• Membership benefit utilization management

• Verification and assessment of pre-authorization requests and claims

• Hospitalizations management and cost optimization

• Review and pre-screening of received claims

• Customer service-handling calls, addressing client queries on all touch points

• Maintain proper departmental standards

• Process/adjudicate claims

• Case management through hospital visits

Required Qualifications:

• Bachelor’s degree in Nursing/Diploma in Nursing or Clinical Medicine

Experience:

• At least 1 year technical knowledge in medical insurance or hospital setting.

Competencies

• Understanding of health insurance operations and concepts

• Knowledge of medical claims processes and procedures

• Stakeholder management

• Customer service