Nurse Job in Kenya(One Year Fixed Term Contract)

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Overall Job purpose
Reporting to the care supervisor the role holder shall maintain constant contact with hospitals to ensure continuous well-being of all the stake-holders and handling of medical claims with efficiency and accuracy.

Key responsibilities
1.Pre-authorise scheduled and non-scheduled admissions within the set guidelines
2.Liaise with the hospitals and doctors for prompt submission of the admission summary form
3.Monitor procedures being carried out on patients and see to the general wellbeing of the patient
4.Assess and authenticate inpatient and outpatient medical claim documents
5.Revise reserves after discharge of a member
6.Ensure smooth discharge process and co-ordinate any necessary post-hospitalisation care
7.Visit health care Institutions in the assigned region to confirm admissions.
8.Prompt collection of claims paid out of policy liability
9.Process reimbursements within the stipulated time
10.Assist in carrying out verification and medical audit of claims invoices before settlement
11.Handling of the 24hr helpline.

Knowledge, experience and qualifications required
1.Diploma in Nursing
2.Basic understanding of insurance concepts
3.1-2 years’ experience in case and claims management
4.Professional qualification in ACII, IIK is an added avantage

Technical Competencies
1.Registered Nurse with Nursing Council of Kenya
2.Knowledge of case management processes and procedures
3.Knowledge of insurance regulatory requirements and concepts
4.Proficient in use of Microsoft office suites and packages

Essential Competencies
1.Learning & Researching
2.Working with people
3.Applying Expertise and Technology
4.Delivering Results and Meeting customer expectations
5.Following instructions & Procedures
6.Adhering to principles and values

Desirable Competencies
1.Achieving personal work goals and objectives
2.Writing and Reporting
3.Analysing
4.Planning & Organizing
5.Adapting and responding to change
6.Coping with pressures and setbacks

Closing Date:

Friday, June 16, 2017

Key Skills/Specialization:

Diploma in Nursing

Basic understanding of insurance concepts

1-2 years’ experience in case and claims management

Professional qualification in ACII/AIIK is an added advantage

Click here to apply

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