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 quotationsRegister new business – as per targets agreed on the departmental budget.Source from renewing clients and cross selling with General Insurance clientsCover write up to clients for reviewPolicy documents issuingProper 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 facilitiesAdvising doctors on referral of patients with chronic illness to cheaper facilitiesCapping/reviewing of undertaking through advise through letters to providers where and when necessary to avoid exceeded limits and hospitals/doctors taking advantagesSending undertakings to providers within the timelinesEnsure all clients queries are responded to timely & professionally in line with GA procedure and policiesContact clients for conducting cover presentations and health talks ReconciliationsProviders reconciliation and liaise with brokers on where member accessed service not authorized which needs to be paid to providersSending invoices of exceeded limits to Brokers / Companies for payment Knowledge, Skills and AbilitiesComputer skills.Good communication Skills.Ability to make decisions and solve problems.Insurance knowledge in underwriting procedures.University degree or equivalent.3 years in a busy medical underwriting department.Insurance Professional qualification (ACII, AIIK).Ability to meet strict deadlines and targetsReady and willing to work in Mombasa.NB: Please indicate your notice period and current salary on your C.V.If you meet 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 on or before 20th June 2013.