Purpose:
Responsible for overseeing the entire claims processing, which includes receiving, vetting, and capturing for payments, to ensure prompt settlement of valid claims.
PRIMARY RESPONSIBILITIES:
• Supervise and monitor claims Vetting and Processing.
• Coordinate with the claims team to ensure all providers are paid on time.
• Investigate and follow up claims with unusual trends and high-cost providers.
• Approve payments for all executed discharge vouchers for amounts within specified limits.
• Coordinate correspondence with providers and clients on any claims concerns.
• Coordinate with the accounts team to ensure provider reconciliation is done.
• Coordinate with provider management to appoint, terminate, and suspend providers into/from the CIC panel.
• Communicate risk improvement measures for implementation to the underwriting department by monitoring claims experience trends.
• Compile monthly claims reports Mission Status Reports (MSR) and review, analyze, approve, and/or repudiate claims.
GENERIC DUTIES
• Carry out performance appraisal, coaching, and mentoring staff.
• Participate in planning and budgeting for the department.
PERSON SPECIFICATIONS
• Bachelor’s degree in a related field.
Professional Qualifications
• Uganda Registered Nursing (URN) diploma
Experience
• Minimum of five (5) years relevant experience
Essential Knowledge/Skills and Experience Required:
• Superior negotiating skills
• Excellent communication skills
• Strong management and leadership skills
• Relationship management
• Excellent customer care
• Technical competence in insurance
• Basic knowledge of regulations by UIA and IRA(U)
Essential Behavioral Competencies:
• People management
• Good coaching skills
• Commercial awareness
• Strong leadership skills
• Outstanding cross-functional coordination ability
• Ability to “constructively dissent”
• Ability to build strong relationships across the organization
CIC Insurance Values:
CIC Insurance Group is committed to providing excellent service and spurring further growth, and employees must align their behavior to the following core values as critical to driving their performance.
• Integrity- Be fair and transparent
• Dynamism- Be passionate and innovative
• Performance- Be efficient and results-driven
• Co-operation- Live the Co-operative spirit
If you have the aforementioned professional and academic qualifications and you are ready to execute the above mandate, kindly send your resume to the address below indicating on the subject of your email the job title. For example Ref: Application for Assistant Business Development Manager Medical. Strictly apply through email: careers@ug.cicinsurancegroup.com
The application should reach us by close of business on 14th December 2023. Please note that only short-listed candidates will be contacted.