Application deadline date has been passed for this Job.
OneLife
Job Overview
ROLE PURPOSE
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
Minimum Qualifications:
Must have at least a first degree from a recognised university in accounting/finance, CIMA/ACCA or ZICA
Minimum Experience:
Minimum one year of hands on accounting experience is required.
Send your CVs to Careers@one.co.zm