Responsible for processing payments, reconciliation of Health Care Providers statements, regular and periodic reporting and providing support to the business as required.
- Reviewing of payment listings and prepare provider remittances
- Manage all reconciliations with the Health provider’s, sign-offs and related documentation
- Prepare claims reports when required
- Maintain sound business relations with HCP’s and manage HCP network
- Engage with the health providers and ensure accounts are reconciled and signed off on a quarterly basis
- Conduct retrospective claims audits and communicate with Claims and Health Risk Management
- Regularly update on Claims on reconciliations and status of the HCP network
- Prepare periodical reports as requested from time to time
- Help resolve payment and claims inquires and follow up with providers to ensure problems are resolved.
- Manage the refund process in relation with claims team
- Assist the Claims/Health Risk Department detect fraudulent activities on claims
- Render support to the Health Risk in managing the network
- Participate in annual product structure review
- Build and maintain relationships with clients and stakeholders
- Deliver client-centric processes and solutions
- Attend to walk in clients and provide the necessary assistance
- Develop and maintain productive and collaborative working relationships with peers and stakeholders
- Take ownership for driving own career development
- Identify solutions to enhance cost effectiveness and increase operational efficiency
Must have at least a first degree from a recognised university in accounting/finance, CIMA/ACCA or ZICA
Minimum one year of hands on accounting experience is required.
Send your CVs to Careers@one.co.zm