BACKGROUND

Prime Insurance Ltd is an insurance company, established in 1995 and licensed by the National Bank of Rwanda (BNR) to offer general insurance services.

JOB SUMMARY

To ensure prompt processing of medical claims.

PRINCIPAL ACCOUNTABILITIES.

• 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
• 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 Axxiss and its integration with other systems.

Qualifications and experience

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

Skills and competencies

• Good communication and negotiating skills
• Good attention to details and accuracy
• Good analytical and monitoring skills
• User IT skills in database management and office systems.
• Good interpersonal skills
• Thorough understanding of policy covers/wordings and their interpretation as pertaining to claims.

NB: Only shortlisted candidates will be contacted.

• 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
• 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 Axxiss and its integration with other systems.

• Good communication and negotiating skills
• Good attention to details and accuracy
• Good analytical and monitoring skills
• User IT skills in database management and office systems.
• Good interpersonal skills
• Thorough understanding of policy covers/wordings and their interpretation as pertaining to claims.

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