Job Description
Reporting to the Senior Risk Health and Wellness Officer
Duties and Responsibilities
The main responsibilities of the job are:
• Reviewing claims to identify errors, fraud, and trends.
• Pre-authorizing hospital admissions and monitoring member benefits.
• Registering and following up with patients enrolled in the chronic disease management program.
• Conducting workplace-based wellness programs for corporate clients.
• Investigating service providers and members with suspicious claiming patterns.
Qualifications and Experience
Qualifications:
• Diploma in Nursing (Please note that a Nursing background is a must).
• Diploma or Degree in Insurance and Risk Management, or equivalent, is an added advantage.
• Diploma in Theatre Nursing and/or Midwifery is an added advantage.
Ideal Candidate must:
• Have at least 2 years’ experience in claims investigations, case management, and implementation of wellness programmes within a medical aid environment.
• Possess excellent investigative, problem-solving, and decision-making skills.
• Demonstrate a strong client focus.
• Have good written and verbal communication skills.
• Be a person of integrity, with the ability to handle sensitive information confidentially and transparently.
How to Apply
All interested, qualified, and experienced candidates who meet the above requirements must email their current CVs along with certified copies of educational and professional qualifications to hr@cellinsurance.co.zw, indicating the subject as "Risk Assessor Position". Please include details of your current and expected remuneration.
