Claims Assessors X 2 Posts || Medical Insurance Firm

  • Harare

Medical Insurance Firm

DUE: 07 NOV 2023
Job description:  A leading medical insurance firm is looking for suitably qualified individuals to fill in the position of CLAIMS ASSESSOR  that have arisen within the organization

  • Screening and processing of claims for members adhering to turn-around times
  • Pre-assesses claims received to ensure compliance with the normal schedule of benefits, whether the dates of treatment fall within the cover period etc
  • Keeping record of all claims received, processed and rejected; reprocesses adjusted claims where necessary
  • Attending to members’ and providers’ on service queries as well as advising members on rules and benefits; liaises with other departments for appropriate action
  • Reports system errors picked up during assessing to the supervisor for logging with IT department.
  • Calculates awards and shortfalls on pro forma invoices, informs members on affordable options.
  • Applies for appeals on ex-gratia and waivers
  • Degree and diploma in Nursing
  • Degree or diploma in Risk and insurance an added advantage
  • Knowledgeable with claims processing systems e.g. Health Information Management System HMS.
  • Experienced in claims Authorization processes
  • Experience in the medical aid sector an added advantage
  • Good interpersonal relationships
  • Fluent in English, Shona and Ndebele
Applicants to send CVs to  or on whatsapp 0773 773 385 before 7 November  2023