Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.
Job Description
To ensure prompt processing of medical claims.
- Manage Claims Ratio as per target
- Use claims tariff during claims payment and signing with providers
- Prompt claims settlement as per agreement with providers
- Reconcile service provider account and close issues arising
- Enhance claims documentation for better adjudication
- Pharmacy claims management
- Smart claims monitoring
- Major provider management
- Contain Optical claims
- Reduce drug cost through implementation of Pharmacy Book
- Claims vetting and adjudication
- Effective communication
- Provider and customer Email management
- Complaints resolution time
- Management of reimbursement Claims
- Compliance to Procedure Manuals
- Ensure complete and efficient implementation of e-Oxygen and its integration with other systems.
- Departmental meeting
- Process reviews yearly
- Individual Performance management
- Report your duties monthly on time (on 5th of the month)
- Any other task as assigned by your Line Manager
Skills
Education
Closing Date
02 October 2024
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