We are looking for a senior registered nurse or registered general nurse. The incumbent will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out.
• Verifying, validating, adjudicating and batching of claims.
• Initiating recovery process on identified fraudulent claims.
• Checking for possible fraudulent claims from existing claims set.
• Reversing and reprocessing claims emanating from queries.
• Verifying and Adjudicating claims captured for correctness and compliance.
• Reviewing and managing claims in line with targets, processes and within agreed timelines.
• Adjudicating claims manually flagged in the system at various levels.
• Attending to enquiries on benefits and products to members, prospective client and service provider.
• Providing customers with accurate product and service information in an efficient manner.
• Dealing with all customers in a professional and empathetic manner.
• Communicating the claims process to both employer and employees as set out in the claim's management process
• Diploma in Nursing.
• 3 years' experience in a similar or related environment.
• Knowledge of business policies, processes and procedures, legal compliance and claims environment.
• Ability to work in a team environment and supervise a small team.
• Ability to work under pressure.
• Advanced Excel Skills.
• High standard of accuracy with attention to detail.
Candidates meeting the below criteria should forward the, Curriculum Vitaes (CVs), copies of certificates and Application letters to the following email address:
applications@clientsure.co.zw
Applications should be sent by and not later than 31 May 2021