Wednesday, June 19, 2013

Medical Division Officer GA Insurance

Job Title: Medical Division Officer 

Reporting to: 
Manager – Medical Division.

Job Summary: Coordinate and manage all: Business renewals, Marketing, Underwriting, Claims, undertaking and Customers service at Branch level.

Detailed Duties and Responsibilities
  • Ensuring business renewals and follow ups.
  • Processing business quotations
  • Register new business – as per targets agreed on the departmental budget.
  • Source from renewing clients and cross selling with General Insurance clients
  • Cover write up to clients for review
  • Policy documents issuing
  • Proper client documentation on file.
  • Minimize losses by ensuring thorough vetting of all claims before forwarding them for approval.
  • Vetting of claims, checking on what is payable and not payable, either due to the nature of illness or mode of treatment or payment within the Kenya Medical Practitioners & Dentist Board guidelines.
  • Go through pre-authorization forms and scrutinize forms especially for clear diagnosis management and nature of treatment.  Requesting for further information/medical reports Liaise with doctors, brokers and clients at large for patient admissions
  • Advise members on how best to utilize their benefits by recommending cheaper facilities and cheaper options e.g. maternity packages, chronic management facilities
  • Advising doctors on referral of patients with chronic illness to cheaper facilities
  • Capping/reviewing of undertaking through advise through letters to providers where and when necessary to avoid exceeded limits and hospitals/doctors taking advantages
  • Sending undertakings to providers within the timelines
  • Ensure all clients queries are responded to timely & professionally in line with GA procedure and policies
  • Contact clients for conducting cover presentations and health talks Reconciliations
  • Providers reconciliation and liaise with brokers on where member accessed service not authorized which needs to be paid to providers
  • Sending invoices of exceeded limits to Brokers / Companies for payment   
Knowledge, Skills and Abilities
  • Computer skills.
  • Good communication Skills.
  • Ability to make decisions and solve problems.
  • Insurance knowledge in underwriting procedures.
Credentials and Experience
  • University degree or equivalent.
  • 3 years in a busy medical underwriting department.
  • Insurance Professional qualification (ACII, AIIK).
Special Requirements
  • Ability to meet strict deadlines and targets
Job Title: Record Files Data Management
Job Summary: To facilitate a smooth flow of information from the files, between the Underwriters and the records department by updating files and other related tasks.

Main Duties and Responsibilities
  • Updating the marine folders and box-files from inception to finality
  • Manual premium data control
  • Updating the U/W files by separating the active and lapsed ones
  • Creating a general file of various clientele by placing all the necessary mails and correspondence
  • Filling all the policy endorsements in the respective policy binders
  • Attaching all policy mclarens reports and correspondences in the respective marine certificates
  • Liaising with ICT department during reconciliation of premiums
  • Liaising with claims department either to retrieve or furnish them with general U/W information
  • Retrieving non-motor files with occasional retrieval of motor and claim Files
Knowledge, Skills and Abilities
  • Computer skills
  • Communication skills
  • Personal drive and initiative
Credentials and Experience
  • O- level education
  • 1 year experience

If you have the above minimum requirements, send your c.v to indicate the position applied for on the email subject line so as to be received not later than 20th June, 2013.
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