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23 Apr 2021

Senior Claims Analyst at UAP Group

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Job Description

UAP Group

Old Mutual Limited (OML) is a premium African financial services group that offers a broad spectrum of financial solutions to retail and corporate customers across key markets in 17 countries. Our primary operations are in South Africa and the Rest of Africa, and we have niche businesses in Latin America and Asia. We have 12 million customers and 31,000 employees as at the end of 2017 and with over 170 years of heritage across sub-Saharan Africa, we are a crucial part of the communities we serve and broader society on the continent. The business is listed on the Johannesburg, London, Zimbabwean, Malawian and Namibian stock exchanges. The UAP Old Mutual Group comprises of three key players as a result of the acquisition of a controlling stake in Faulu in 2014 and UAP in 2015 by Old Mutual. The acquisition resulted in Old Mutual Kenya and UAP Holdings (www.uapoldmutual.com) as well as Faulu Microfinance Bank (www.faulukenya.com) forming one of the largest financial services groups with a growing footprint in East and Central Africa. The Group currently has operations in Kenya, Uganda, Tanzania, South Sudan and Rwanda.  The Group now offers customers a comprehensive and enhanced range of financial services which include Investment, Insurance, Banking, and Savings as well as a wider and more accessible distribution network. The wider group also offers broad career growth prospects for employees. It therefore wishes to fill the below vacant position with qualified, experienced, and talented individual to strengthen its portfolio as a Pan – African Financial Services Group. The positions’ details are further outlined below.

Role Title:

Senior Claims Analyst-1 Post

Business Unit(s):

Rwanda

Business /Function:

Senior Claims Analyst

Location:

Rwanda

Reports To:

Health Manager

MDP Level:

Manager of self

Role Size

M

Job Summary

Analyses and reviews insurance claims for accuracy, completeness, and eligibility. Reviews claims for eligibility to be reimbursed. Being a Claims Analyst maintains updated records and prepares required documentation. Assists in controlling the cost of processing claims.

Key tasks and responsibilities

  • Manage medical Claims and ensure proper settlement
  • Supervise medical Claims team and ensure targets are met as per Business plan.
  • Review and approve Claims before payment to service providers
  • Provide reports of claims received and not paid (outstanding claims) weekly and Monthly.
  • Manage Claims loss ratio and make appropriate actions.
  •  Appraise and contract KPI’s of Claims team and maintain deadlines
  • Motivate Claims teams and ensure low level rate of staff turnover.
  • Review Retail onboarding application forms and give proper guidance on risk acceptance to medical underwriting.
  • Receive, review and document application for partnership and plan for medical procurement committee meeting as per the plan.
  • Plan for provider engagement and advise business accordingly.
  • Monitor and support scanning materials to ensure constant supply
  • Facilitate archiving of scanned claims documents after payment.
  • Maintain an updated record of all files in registry to facilitate easy tracing of files
  • Appraise files, transfer and organize arrangement of the non-current files in the Archives to ensure only current files are kept in the registry and non-current files are transferred and kept in the archives.
  • Recommend disposal / destruction of files to ensure adequate utilization of filing space
  • Keep an inventory of available space and recommend future needs for an efficient registry.
  • Coordinate, set and monitor targets for the Registry Operations to ensure smooth running of the registry.
  • Ensure security of files in the registry and that sensitive information remains confidential.
  • Prepare over Claims performance monthly reports for the Manager’s review.

Academic/Professional Qualifications; experience; skills and competencies

  • University degree in any health-related field.
  • Basic Insurance qualification
  • General experience of 5 years with 2 years’ experience in similar role
  • Good interpersonal skills
  • Good communication and negotiating skills.
  • Thorough understanding of policy covers/wordings and their interpretation as pertaining to claims.


Method of Application

Submit your CV and Application on Company Website : Click Here

Interested candidate are requested submit their applications by 5.00 p.m. 30th April 2021.



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