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