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.