Job Summary

To ensure prompt processing of medical claims.

Key tasks and responsibilities

• Audit and verify that all invoices are captured correctly in E-Oxygen.
• Bar coding and scanning of medical claims.
• Capture all invoices and reject ones not payable by OM.
• Return all invoices not payable to providers / members.
• Maintain a Database on rejected invoices for reference and retrieval.
• Capture Reimbursement claims and assist in cheque dispatch.
• Process Funeral Benefit cheques within 48 hours.
• Prepare schedules for claims other OM subsidiaries.
• Assist in pulling Membership utilization reports
• Maintain database on all reimbursement claims.
• Prepare and facilitate in medical claims file.
• Ensure compliance with SMART (when rolled out)

The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual Insurance Rwanda. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.

Any other responsibilities assigned by line manager or the senior management team.

Qualifications and experience

• University degree in health-related field
• Basic Insurance qualification
• Minimum of 3 years experience

Skills and competencies

• Good communication skills
• Good interpersonal skills
• Good attention to details and accuracy
• Thorough understanding of policy covers’
• Integrity and honesty

• Audit and verify that all invoices are captured correctly in E-Oxygen.
• Bar coding and scanning of medical claims.
• Capture all invoices and reject ones not payable by OM.
• Return all invoices not payable to providers / members.
• Maintain a Database on rejected invoices for reference and retrieval.
• Capture Reimbursement claims and assist in cheque dispatch.
• Process Funeral Benefit cheques within 48 hours.
• Prepare schedules for claims other OM subsidiaries.
• Assist in pulling Membership utilization reports
• Maintain database on all reimbursement claims.
• Prepare and facilitate in medical claims file.
• Ensure compliance with SMART (when rolled out)
• The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual Insurance Rwanda. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.
• Any other responsibilities assigned by line manager or the senior management team.

• Good communication skills
• Good interpersonal skills
• Good attention to details and accuracy
• Thorough understanding of policy covers’
• Integrity and honesty

• University degree in health-related field
• Basic Insurance qualification