Medical Insurance Care and Case Managers, Insurance Administrator & Claims Analyst at AON
Vacancies: Nairobi and other counties
Ref: MACA/H LC/O/06/201 5
Job Summary: Database management, claims adjudication & processing and card processing & management.
- Accurate and timely day to day membership database and card processing / management.
- Timely processing and management of medical cards
- Thorough, adjudication and payment of claims in line with the scheme policy coverage
- Claims fraud detection, reporting and management
- Effective engagement with service providers for required information to assist in claim settlement
- Carrying out all administration duties of the medical scheme as and when required
- Preparing of management reports as per provided guidelines
Job Summary:
- Diploma in Business administration or in any other relevant field, coupled with 1 year relevant experience
- Computer literacy and familiarity with standard office computer applications
Skills & Attributes
- Analytical and numerical skills
- Good organizational and planning skills
- Good interpersonal and communication skills
- High personal integrity and honesty
If you meet the above requirements, please email your application and resume to aon_rec@aon.co.ke on or before close of business on 25th June 2015 quoting the job title and reference as the subject.
Only shortlisted candidates will be contacted.
Vacancy: Medical Insurance Care and Case Manager – In all 47 Counties
Ref: CM/HLC/1 8/06/2015
Job Summary: To ensure that all individual members receive appropriate, reasonable health care services by assessing, planning, implementing, coordinating, monitoring and evaluating options and services required to meet an individual’s health needs and access to care through the preferred provider network to promote quality and cost effective outcomes.
Job Functions:
- Conduct member education
- Conducting health education forums towards achievement of total wellbeing
- Authorisation of admison to appointed MSP’s, Daily visitation and Discharge planning.
- Ability to interpret medical policies in managing healthcare clients needs.
- Maintain good PR with the MSPs staff and train them constantly to maintain seamless integration of care.
- Accreditation of medical service providers and recommendation for appointment, termination as appropriate
- Carrying out medical audits on the service provider facility to ascertain quality assurance.
- Maintain good client service as well as addressing all clients’ queries to eliminate complaints and enhance customer satisfaction.
- Coordination and follow up and referral of chronic illness patients on outpatient basis
- Discounts negotiations with the Doctors on procedure charges and consultation
- Co-ordination of inter hospital transfers, medical evacuation, step down care, home care & nursing, care upgrade as when required as per clinical assessment
Minimum Qualifications:
- Minimum of 3 years’ experience, preferably care management in a medical insurance firm.
- Computer skills and especially operating MIS
- Diploma in Nursing or Clinical Medicine
- In-depth knowledge of care and health management
Minimum Qualifications:
- Confidentiality
- Good Communication & PR skills
- Ability to meet strict guidelines
- Analytical & Focused Individual with attention to detail
- Ability to work under pressure
- Technical Competence
If you meet the above requirements, please email your application and resume indicating at least two (2) counties where you can report to immediately, to aon_rec@aon.co.ke on or before close of business on 25th June 2015 quoting the job title and reference as the subject.
Only shortlisted candidates will be contacted.
