To provide operational Administrative support to site management and employees, on matters including but not limited to: Medical claim processing, Medical Insurance, Assist EHS&TAdministration.
Duties and Responsibilities:
- Guiding employees on best work practice by ensuring safe work processes are Complies with all HS&E policies, procedures and instructions. This includes the correct use of safety devices and protective equipment, prompt reporting of any hazardous situations, which they cannot themselves correct, making the necessary changes to eliminate or control the hazard and reporting immediately any accident or injury which arises in the course of their work.
- Complies with all company policies and procedures that are displayed and amended from time to time.
- Provider Management
- Provider Visits (Physically and Telephonically)
- Price List Control and Negotiation
- Desk Clerk Deployment
- Supply of Claim Forms to Providers
- General Duties
- Attend meetings to exchange ideas ajira and information and share good practice.
- Taking the lead in resolving problems and ensuring efficient execution in the AUMS’s best interests.
- Ensure that all claims are passed to the Project Manager/Alt Project Manager for authorization.
- Balance records to accountancy tabulations periodically and at year end.
- Assist the Management in the closure of accounts and the preparation of budget estimates both for expenses and charges to services and external interests, using spreadsheets and other computer facilities as appropriate.
- You must cooperate in all matters relating to Health and Safety and implement all procedures for your job role. The identification of Health and Safety related risks within the working environment must be highlighted to your management.
- Review and negotiate contractual obligations placed on the organization.
- Maintain familiarity with legislation and developments in Medical practice
- Health care fraud: To identify and report any health care fraud and abuse.
- To assist and perform other duties as reasonably assigned and directed by the supervisor in the EHS&T administration.
- Customer Service
- Payment Information to Providers (Remittance within 24 hours)
- Timely Payments to providers
- Timely Reconciliation with providers
- Provider Workshop
- Ensure Good Customer Service to Providers
- Bachelor of Science (BS) degree programs in healthcare administration or related field.
- Experience in medical claims processing, data processing, report generation, and analysis, performance management, medical insurance, knowledge of medical Tariff codes & treatment protocols (STGs), project management skills.
- Possess a proactive nature and the ability to work under pressure.
- Ability to solve problems and escalate issues prior to them occurring.
- Ability to work autonomously and to strict deadlines.
- Computer literate – excel, word, PowerPoint
- High level of integrity.
- Strong command of both spoken and written English and Swahili
- Strong observation and analytical skills along with attention to detail.
- Strong interpersonal, customer-oriented mindset, management, and communication skills.
If you have the necessary skills, drive, and experience to be an asset to AUMS Operations Team, we welcome your interest and encourage you to apply.
Only applications with a current Resume attached will be considered for employment. Please send your CV along with a detailed covering letter via email email@example.com
Application letters should reach the above on or before 22 nd July 2020, 18hr00.
BEWARE OF CON MEN! AUMS(T)Limited does not receive money in exchange for a job position. Should you be asked for money in exchange for a job offer or suspect such activity, please report this immediately by calling +255 682 660 124 or+255 682 660 256 or+255 682 660 893.