Insurance Manager Job Description:

Job Title:  Insurance Manager
Reports To:  Hospital General Manager
Key Relationships: Handling Insurance Claims for service providers.

Job Summary: To help achieve maximum settlement and recovering of all bills from the insurance service providers. Enabling correct compliance with all stipulated rules and procedures and ensuring timely payments by the service providers to the hospitals as provided for in the contract agreement.+

Job Duties.
The insurance manager will be responsible for the day-to-day operation of all insurance activities within the hospital. Ensuring that all insurance claims are professionally conducted as per the contracts. Leading the insurance team and ensuring all forms are well filled, updated with zero mistake.Constantly being in contact with the insurance service providers and maintaining utmost customer relationships.
The general duties will include:
  • Act as liaisons among governing boards, medical staff,departments’ heads and insurance service providers.
  • Organize, direct, control and coordinate medical and health services in relation to policies set by hospital and insurance service providers.
  • Develop procedures for quality assurance, patient services, department activities in relations to insurance and claims management.
  • Leveraging insurance contracts with quality healthcare providers for optimal financial results.
  • Evaluating and resolving claims on losses of varying value and complexity.
  • Ensuring that all the physical and computerized systems are correctly reconciling with appropriate pricing and items
  • Reaching out to health delivery systems and evaluate their services based on company mandated criteria and developing a medical provider network by strategically negotiating contract constraints.
  • Ensuring compliance with contract guidelines, preparing insurance debts collection strategy, overseeing insurance claims for accuracy.
  • Customizing schedules, attending task force meetings, and reporting to insurance company executives on problems with their services.
  • Ensuring promptness in recovering of the debts from the insurances service providers as stipulated in the contracts.
  • Introducing new products and promoting them through regular visits and communication with intermediaries.
  • Increasing profitability of existing product lines by encouraging clients to use added value services wherever possible;
  • Consulting on the most effective cover for a particular need;
  • Delivering good customer service by responding swiftly to queries and concerns from clients and stakeholders
  • Maintaining detailed knowledge of new and existing services by liaising with colleague.
  • Ensuring credibility with clients by maintaining detailed knowledge of current market conditions and competitors' products.
  • General Administration duties as may be required from time to time.

Education:   Degree in Accounting/Business Administration with IT preferred.

Required Skills:

  • 5+ years of experience in insurance claims
  • Experience in general debtors collection;
  • Excellent IT skills.
  • Proven honesty and integrity with excellent customer service skills;
  • Detail-oriented with excellent communication skills. Excellent communication and listening skills
  • The ability to explain complex information clearly and simply
  • Attention to detail.
Apply On-line Through

Human Resources Manager -
Tasakhtaa Hospital
P.o. Box 1116.
Mjini Magharibi
Application Deadline: 15-01-2017