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 triza@gakenya.com 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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