Summary
Date Posted: Thursday, January 30, 2020 , Base Salary: Not Disclosed

JOB DETAILS:
Old Mutual Limited (OML) is a premium African financial services group that offers a broad spectrum of financial solutions to retail and corporate customers across key markets in 17 countries. Our primary operations are in South Africa and the Rest of Africa, and we have niche businesses in Latin America and Asia. We have 12 million customers and 31,000 employees as at the end of 2017 and with over 170 years of heritage across sub-Saharan Africa, we are a crucial part of the communities we serve and broader society on the continent. The business is listed on the Johannesburg, London, Zimbabwean, Malawian and Namibian stock exchanges. The UAP Old Mutual Group comprises of three key players as a result of the acquisition of a controlling stake in Faulu in 2014 and UAP in 2015 by Old Mutual. The acquisition resulted in Old Mutual Kenya and UAP Holdings (www.uapoldmutual.com) as well as Faulu Microfinance Bank (www.faulukenya.com) forming one of the largest financial services groups with a growing footprint in East and Central Africa. The Group currently has operations in Kenya, Uganda, Tanzania, South Sudan, and Rwanda. The Group now offers customers a comprehensive and enhanced range of financial services which include Investment, Insurance, Banking, and Savings as well as a wider and more accessible distribution network. .

Job Responsibilities
• Manage Claims Ratio as per target
• Use claims tariff during claims payment and signing with providers
• Prompt claims settlement as per agreement with providers
• Reconcile service provider account and close issues arising
• Enhance claims documentation for better adjudication
• Pharmacy claims management
• Major provider management
• Contain Optical claims
• Reduce drug cost through implementation of Pharmacy Book
• Claims vetting and adjudication
• Management of Intercompany claims recoveries
• Provider and customer Email management
• Customer and medical provider Complaints resolution on time
• Management of reimbursement Claims
• Ensure the complete and efficient implementation of e-Oxygen and its integration with other systems.
• Report your duties monthly on time (on 5th of the month)

Job Skills: Not Specified

Job Qualifications
• Degree in Health-related studies (General Medicine, Nursing, Laboratory sciences, clinical medicine, and Pharmacy)
• 2 years ‘experience in the same role
• Good communication skills/Interpersonal skills/ Computer literacy/people management skills and/or any other relevant skills.

Job Education Requirements: Not Specified

Job Experience Requirements: Not Specified

Work Hours: 8

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Job application procedure
Interested candidates are requested to submit the Cover Letter and the CV with 3 references Applicants must possess or be in the process of applying for a POLICE CLEARANCE CERTIFICATE as at the time of making an application. To apply please click here  

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