Medical Claim Analyst at Bliss Healthcare

Reporting Supervisor:   MEDICAL TEAM LEADER

KEY RESPONSIBILITIES AND DELIVERABLES

Core Responsibilities

• Clinical officer has to be well equipped with the latest trends and technologies used.
• Expert in analyzing actual and fake treatments claims.
• Expert in drafting the process in and out.
• Smart in tackling various types of clients.
• Clinical officer has to be the one and only stop for whole process execution for clients.
• Clinical officer is incumbent for the billing, filing, updating and processing of medical claims related to patient diagnoses, treatments and medications.
• Process Company’s response to claims.
• Regular liaison with insurers, loss adjusters/appointed experts.
• Utilizing new Claims repository.
• Perform data entry and processing.
• Formulate objectives and processes.
• Monitoring inventory records.
• Supervising the educational material provided to patients by clinical officer.
• Evaluating the Preparation and delivery of claims presentations by clinical officer.
• Provide cover for colleagues in their absence, ensuring that the handling of their claims is kept up to date.
• Liaising with other healthcare personnel for efficient delivery of patient care.
• Treating or referring them to respective specialists.
• Responding to mails, calls, and medical related queries on social media platform.
• Any other duties as may be assigned.

JOB REQUIREMENTS   -        100%

Minimum Qualifications 

• Diploma in community oral health/optometrist/nursing/clinical medicine and surgery/community health.
• Registered and licensed by the relevant medical body. 

Experience

• Minimum of 2 years of experience in relevant medical field 

Technical/Behavioural Skills

• Computer literacy
• Decision making
• Ability to learn
• Morally upright
• Clear communication
• Empathy
• Attentive listening
• Positive attitude
• Willingness to go the extra mile
• Knowledge about products and services

Language Skills

• English (Preferred)
• Swahili