Summary
Date Posted: Friday, September 27 2024, Base Salary: Not Disclosed

JOB DETAILS:
To ensure prompt processing of medical claims.

PRINCIPAL ACCOUNTABILITIES.
• 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
• Smart claims monitoring
• Major provider management
• Contain Optical claims
• Reduce drug cost through implementation of Pharmacy Book
• Claims vetting and adjudication
• Effective communication
• Provider and customer Email management
• Complaints resolution time
• Management of reimbursement Claims
• Compliance to Procedure Manuals
• Ensure complete and efficient implementation of e-Oxygen and its integration with other systems.
• Departmental meeting
• Process reviews yearly
• Individual Performance management
• Report your duties monthly on time (on 5th of the month)
• Any other task as assigned by your Line Manager

Qualifications and experience
• University degree in health-related field
• Basic Insurance qualification

Skills and competencies
• Good communication and negotiating skills
• Good attention to details and accuracy
• Good analytical and monitoring skills
• User IT skills in database management and office systems.
• Good interpersonal skills
• Thorough understanding of policy covers/wordings and their interpretation as pertaining to claims
Integrity and honesty

Job Experience: No Requirements

Work Hours: 8

Experience in Months:

Level of Education: Bachelor Degree

Job application procedure

Please visit our careers page through:
https://oldmutual.wd3.myworkdayjobs.com/en-US/Old_Mutual_Careers/details/IT-Business-Analyst_JR-58804?q=rwanda 

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