Medical Claims Assistant
2025-06-16T13:35:41+00:00
Britam
https://cdn.greatkenyanjobs.com/jsjobsdata/data/employer/comp_8009/logo/britam.png
https://ke.britam.com/
FULL_TIME
Kenya
Nairobi
00100
Kenya
Investment
Business Operations
2025-06-30T17:00:00+00:00
Kenya
8
The role involves delivering excellent client service, as well as the accurate processing and payment of Britam Connect medical claims, conducting data analytics, reporting, ensuring high-quality service, customer experience and cost control.
Key Responsibilities:
- Processing of claims and payments for service providers and clients.
- Conduct data analytics and prepare reports of claims for both medical and non-medical claims.
- Communicate with clients and healthcare providers to ensure that services rendered are within policy limits and guidelines.
- Review medical reports and claims for compliance with established medical and insurance guidelines.
- Liaise with underwriters to clarify the scope of cover for various schemes.
- Promote the use of generic medications where clinically appropriate to reduce pharmaceutical costs using internal systems and analytics.
- Review and validate documents and other relevant requirements related to claims submitted by providers and clients.
- Ensure all submitted claims are complete, accurate, and compliant with the required documentation.
- Manage and maintain strong relationships with clients, intermediaries, and healthcare service providers.
- Verify and audit both outpatient and inpatient claims to ensure accuracy and mitigate financial and operational risks.
- Provide basic advisory support to claimants regarding their insurance coverage in relation to their claims.
- Respond to internal and external inquiries regarding claim procedures, service providers, and required documentation.
- Maintain and process accurate records of all claims transactions.
- Prepare and maintain claims registers for claims meetings and update relevant claims reports.
- Track, follow up, and ensure timely receipt of all necessary documentation.
- Train service providers on service systems and procedures
Delegated Authority:
- Responsibilities and decisions as outlined in the approved Delegated Authority Matrix.
Knowledge, experience and qualifications required
Qualifications, Knowledge, and Experience Required:
- Degree in Bachelor of Actuarial Science, Bachelor’s degree in Data Science, Computer Science or its equivalent, data analytics skills will be most desirable.
- Minimum of 1 year in medical claims processing and data analytics.
Processing of claims and payments for service providers and clients. Conduct data analytics and prepare reports of claims for both medical and non-medical claims. Communicate with clients and healthcare providers to ensure that services rendered are within policy limits and guidelines. Review medical reports and claims for compliance with established medical and insurance guidelines. Liaise with underwriters to clarify the scope of cover for various schemes. Promote the use of generic medications where clinically appropriate to reduce pharmaceutical costs using internal systems and analytics. Review and validate documents and other relevant requirements related to claims submitted by providers and clients. Ensure all submitted claims are complete, accurate, and compliant with the required documentation. Manage and maintain strong relationships with clients, intermediaries, and healthcare service providers. Verify and audit both outpatient and inpatient claims to ensure accuracy and mitigate financial and operational risks. Provide basic advisory support to claimants regarding their insurance coverage in relation to their claims. Respond to internal and external inquiries regarding claim procedures, service providers, and required documentation. Maintain and process accurate records of all claims transactions. Prepare and maintain claims registers for claims meetings and update relevant claims reports. Track, follow up, and ensure timely receipt of all necessary documentation. Train service providers on service systems and procedures
Degree in Bachelor of Actuarial Science, Bachelor’s degree in Data Science, Computer Science or its equivalent, data analytics skills will be most desirable. Minimum of 1 year in medical claims processing and data analytics.
JOB-68501dad5508a
Vacancy title:
Medical Claims Assistant
[Type: FULL_TIME, Industry: Investment, Category: Business Operations]
Jobs at:
Britam
Deadline of this Job:
Monday, June 30 2025
Duty Station:
Kenya | Nairobi | Kenya
Summary
Date Posted: Monday, June 16 2025, Base Salary: Not Disclosed
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JOB DETAILS:
The role involves delivering excellent client service, as well as the accurate processing and payment of Britam Connect medical claims, conducting data analytics, reporting, ensuring high-quality service, customer experience and cost control.
Key Responsibilities:
- Processing of claims and payments for service providers and clients.
- Conduct data analytics and prepare reports of claims for both medical and non-medical claims.
- Communicate with clients and healthcare providers to ensure that services rendered are within policy limits and guidelines.
- Review medical reports and claims for compliance with established medical and insurance guidelines.
- Liaise with underwriters to clarify the scope of cover for various schemes.
- Promote the use of generic medications where clinically appropriate to reduce pharmaceutical costs using internal systems and analytics.
- Review and validate documents and other relevant requirements related to claims submitted by providers and clients.
- Ensure all submitted claims are complete, accurate, and compliant with the required documentation.
- Manage and maintain strong relationships with clients, intermediaries, and healthcare service providers.
- Verify and audit both outpatient and inpatient claims to ensure accuracy and mitigate financial and operational risks.
- Provide basic advisory support to claimants regarding their insurance coverage in relation to their claims.
- Respond to internal and external inquiries regarding claim procedures, service providers, and required documentation.
- Maintain and process accurate records of all claims transactions.
- Prepare and maintain claims registers for claims meetings and update relevant claims reports.
- Track, follow up, and ensure timely receipt of all necessary documentation.
- Train service providers on service systems and procedures
Delegated Authority:
- Responsibilities and decisions as outlined in the approved Delegated Authority Matrix.
Knowledge, experience and qualifications required
Qualifications, Knowledge, and Experience Required:
- Degree in Bachelor of Actuarial Science, Bachelor’s degree in Data Science, Computer Science or its equivalent, data analytics skills will be most desirable.
- Minimum of 1 year in medical claims processing and data analytics.
Work Hours: 8
Experience in Months: 12
Level of Education: bachelor degree
Job application procedure
Interested and qualified? Go to Britam on britam.taleo.net to apply
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