Job Description
Applications are invited from suitably qualified and experienced persons to fill the above vacancy that has arisen within First Mutual Health Company.
Duties and Responsibilities
Job Specification Reporting to the Claims Supervisor, the successful candidate will be responsible for the following:
• Verifying, validating, adjudicating and batching of claims.
• Initiating the recovery process on identified fraudulent claims.
• Checking for possible fraudulent claims from existing claims set.
• Reversing and reprocessing claims enkindling horn 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 clients and service provides.
• 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.
Qualifications and Experience
• Diploma in Nursing.
• 2 years' experience in it 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.
How to Apply
Candidates meeting the above criteria should forward their Curriculum Vitaes (CVs), copies of certificates and application letters to Group Human Resources via the following email address: careers@firstmutual.co.zw
Applications should be sent by not later than 19 June 2022.
