Resolution Insurance Company Ltd is a
general insurer offering innovative and responsive insurance solutions. We have
learned to adapt in this constantly changing society, and develop comprehensive
products that are relevant to our clients.
The Resolution Insurance brand is
energetic and trendy. In pursuit of our ambitious growth plan, we are looking
to fill the below position in our Underwriting Department.
Medical Underwriter
The Medical Underwriter’s overall
purpose is to minimize the risk exposure and claims costs by proper evaluation
of applicants seeking medical coverage based on their medical and health
status, and aggressive claims analysis.
The jobholder is expected to
demonstrate commitment and loyalty and perform all duties in accordance with
the organization’s office routines and procedures, keeping in mind the overall
business objectives.
Key Outputs
- Coordinate and ensure the set underwriting
rules and recommendations are adopted by the respective
clients/brokers/staff.
- Assess risk and ensure appropriate premiums
are charged
- Adjudicate applications and determine whether
to accept risk and the terms of risk acceptance
- Coordinate with relevant departments on
implementation of proposed health interventions.
- Continuous updating of clients medical history
while overseeing the storage and integrity of medical records.
- Underwrite new and existing policies giving
the relevant recommendations and ensure their placement.
- Conduct research and market intelligence and
develop departmental reports on medical trends.
- Respond to both internal and external client
queries.
Qualifications & Experience
Essential
- Diploma/degree in nursing or clinical
medicine.
- KRCHN certification
- 3-5 years relevant work experience in care
management in a large modern hospital.
- Computer literacy levels in MS Office especial
MS Excel
- Excellent research and report writing skills
Desirable
- Experience in an insurance company in a
medical underwriting capacity.
- Ability to work responsibly with or without
direct supervision.
- Strong Customer Service and interpersonal
skills
- ACII qualification.
Underwriting Executive
The Underwriting Executive’s overall purpose is to ensure live/non-live membership status reports are up to date and available for MSPs or the relevant RIL personnel to avoid denial of services for members or unnecessary costs for inactive-members.
The jobholder is
expected to demonstrate commitment and loyalty and perform all duties in
accordance with the organization’s office routines and procedures, keeping in
mind the overall business objectives.
Key Outputs
- Ensure all MSPs have RI current membership
report for all active members
- Update membership report daily for the
Operations Department ensuring capture of various statuses of memberships.
- Generate reports for qualified international
cover members and ensure international provider has the report on time
- Ensure over-limit members do not access
services.
- Ensure members are on their respective
accounts for co-pay options.
- Generate and communicate card lists to the
respective card printers.
- Archiving and retrieval of all physical
documents in the underwriting process.
- Retrieval of any electronic member documents
requested by other functions in the company.
Qualifications & Experience
Essential
- Diploma in IT.
- At 3 years relevant work experience
- Knowledge of working with MS Office packages.
Desirable
- Business and Accounting knowledge an added
advantage
- Ability to work responsibly with or without
direct supervision
If you believe you are a team player
and would be a valuable resource to this ever growing brand, kindly visitwww.resolution.co.ke By
COB, Monday, 12th January 2015.