Claims Adjudicator
Resolution Health East Africa Limited is a leading Medical Insurance Provider.
Resolution
Health has over 250 medical service providers all across East Africa, a strong
network of hospitals, clinics and doctors.
The Resolution Health brand is energetic and trendy.
In
pursuit of our ambitious growth plan, we are looking to enroll as part of our
Claims Team individuals who have analytical skills with excellent planning and
organizational skills and who can contribute by being an effective team player,
capable of maintaining positive, professional relationships with our Medical
Service Providers (MSPs).
Reporting to the Claims Supervisor, the Claims Adjudicator’s role is to timely and correctly process claims ensuring cost containment and adherence to company policies.
Key Responsibility Areas:
- To receive and
analyze claims for processing;
- To vet and
adjudicate claims for payment;
- To resolve
problems related to claims, by liaising with providers, so as to allow
vetting and adjudication;
- Escalation of non
resolved issues with MSPs to MSP relations within 7 days of initial
contact with MSP;
- To reconcile
disputed claims with providers so as to allow payment
- To prepare
relevant departmental and management reports for analysis by the 5th of
every month
The right
candidate must have the following: Diploma in Nursing or Clinical Medicine
Knowledge of MS Office – A Must 3 years experience in care management in a
large modern hospital In-depth knowledge of care and health management an added
advantage Excellent communication and interpersonal skills
Front Office Secretary (2 Positions)
Resolution Health East Africa Limited is a leading Medical Insurance Provider.
With
over 60,000 members in our fold, we have learned to adapt in this constantly
changing society, and develop products that are effective and relevant to our
members.
Resolution Health has over 250 medical service providers all across East Africa, a strong network of hospitals, clinics and doctors.
The Resolution Health brand is energetic and trendy. In pursuit of our ambitious growth plan, we are looking to enroll as part of our Administration team two individuals who have winning smiles accompanied by excellent communication skills with a customer service disposition and who can contribute by being an effective team player and are capable of maintaining positive, professional office relationships.
Key Responsibility Areas:
- Deal with
visiting clients with decorum; identify their needs so as to accord them
the necessary assistance.
- Receive politely
and respectively telephone calls to offer assistance and route calls.
- To monitor and
ensure the reception area is clean and tidy so as to present the correct
image of the company.
- Receiving,
recording and sorting incoming and outgoing mail and parcels to ensure
correct destination.
- Minute taking
during monthly staff meetings
The
right candidate must have the following:
Advanced diploma in Secretarial Bachelor’s Degree in a business field –an added advantage Knowledge of Microsoft Office At least 2 years experience in a busy front office position with heavy traffic of visitors.
Ability
to handle a busy switchboard.
If you
believe you are a team player and would be a valuable resource to this ever
growing brand, kindly email your application letter, updated CV listing three
references with their email or phone contacts, your age and expected
remuneration package not later than Wednesday 14th November 2012 to
hr@resolution.co.ke.
Ensure that you quote the position on your email.
Only
shortlisted candidates will be contacted.
To find out more about Resolution Health log on to www.resolution.co.ke
My Health, My Life, My Resolution
