PACIS Insurance Company Limited was incorporated in Kenya in October 2004 and licensed to do business in August 2005. It is an initiative of the Catholic Church with a vision to be the icon of reliability and trustworthiness. The Assistant Medical Claims Analyst role is dedicated to evaluating medical claims submitted to the company and determining whether they meet eligibility standards. The role also involves reconciling provider statements and scheduling payments.
Principal Accountabilities
Claims Processing and Provider Reconciliation
Receiving invoices from various service providers and registering them into the system.
Verifying and auditing all medical claims to ensure supporting documents are attached and following up on documents not submitted with service providers/clients.
Accurate capturing of all invoices in the system.
Prompt account reconciliation and sign-offs with service providers and addressing all disputes to completion.
Recommend appropriate payment of disputed billing as necessary.
Negotiate and schedule monthly medical payments for approval.
Prepare and send payment remittances.
Prepare monthly claims, reconciliation, and sign-off reports for management.
Customer Service
Respond to client queries via telephone, emails, and walk-in interactions.
Build and enhance relationships with providers to ensure the Pacis Insurance account with providers is current and active.
Ensure adherence to contracts and service level agreements (SLAs) between providers and the company.
Requirements
Academic Qualifications
A Bachelor's degree in a Business-related course, Statistics, or Accounts.
Professional Qualifications
A Diploma in Insurance (IIK) will be considered an added advantage.
Experience
Minimum of 1 year experience in the claims section of a health insurance department.
Knowledge
Sound understanding of the insurance industry.
How to Apply
Interested and qualified candidates should visit the PACIS Insurance application portal or official website to submit their application. Apply via www.pacisinsurance.com or use the direct application link: Apply Here.
