Claims Officer
International Rescue Committee
- Kakuma, Turkana County
- Contract
- Full-time
- Manage the end-to-end process of SHIF claims, ensuring accuracy and completeness of documentation.
- Review and verify claim forms and supporting documents submitted by healthcare facilities or beneficiaries.
- Input and maintain accurate data related to claims in the designated systems or databases.
- Continuous follow up the claims submitted to SHIF to ensure timely reimbursement of the claims.
- Stay updated with SHIF policies, regulations, and guidelines to ensure compliance in claims processing.
- Interpret and apply SHIF rules appropriately while processing claims to prevent discrepancies or rejections.
- Maintain organized and comprehensive records of all claim-related documents, ensuring confidentiality and accessibility as per organizational policies.
- The claim officer will be required to provide the finance department with accurate information regarding the claims submitted to SHIF for reimbursement to be captured into the financial system.
- Prepare accurate reconciliation of claims report against the funds received bi-weekly and submit to Finance Officer for review. Ensure that all outstanding claims/discrepancies are followed and settled immediately.
- Continuous liaison with Finance department for confirmation of receipt of funds from SHIF to enable you perform the reconciliation report.
- Generate and prepare reports on claim processing activities for internal audits or reporting purposes.
- Liaise with healthcare providers, beneficiaries, and SHIF representatives to resolve any claim-related queries or discrepancies.
- Collaborate with internal teams such as finance, administration, and program staff to facilitate seamless claim processing.
- Conduct regular audits on processed claims to ensure accuracy, compliance, and alignment with SHIF regulations.
- Identify areas for process improvement and contribute to the development of streamlined claim processing procedures.
- Bachelor's degree in Business Administration or Accounting, or related field and 2 years' experience in claims processing or Diploma in either accounting or business administration with 5 years of experience in processing claims.
- In-depth knowledge of SHIF policies, procedures, and regulations.
- Strong analytical skills with attention to detail and accuracy in documentation.
- Proficiency in using relevant software and databases for claims processing.
- Excellent communication skills (verbal and written) with the ability to interact effectively with diverse stakeholders.
- Ability to work independently, manage multiple tasks, and meet deadlines in a fast-paced environment.
- Commitment to maintaining confidentiality and upholding ethical standards in healthcare operations.
- This position may require occasional travel to field locations or healthcare facilities.
- Fluency in English (written and spoken) is required.