Medical Claims Analyst at Old Mutual Insurance Rwanda

Role Title: Medical Claims Analyst - 1 Post

Business Unit(s): Rwanda

Business /Function: Medical Claims Analyst

Location: Rwanda-Kigali

Reports To: Senior Claims Analyst

MDP Level: Manager of Self

Role Size: L

JOB SUMMARY

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

Please visit our careers page through: 

https://oldmutual.wd3.myworkdayjobs.com/en-US/Old_Mutual_Careers/details/Claims-Analyst_JR-58805?q=rwanda

Interested candidates are requested to submit their applications by 5.00 p.m. 1^st October 2024.

Applicants must possess or be in the process of applying for a POLICE CLEARANCE CERTIFICATE as at the time of making an application.

ONLY short-listed candidates will be contacted.