UAP Insurance Careers – Medical Claims Manager

Job Title:    Medical Claims Manager
Organisation: UAP Insurance
Duty Station: Kampala,
Uganda
Reports to: Medical
Operations Manager
About US:
UAP Holdings
Limited is the pan-African Financial Services
Company with a primary purpose of acting as a holding company for the
various UAP businesses.
The Groups origins in Kenya date back to the 1920’s when Provincial Insurance
Company of East Africa was incorporated. UAP Group embarked on a multi-phased
restructuring plan in 2006 to shift from a traditional non-life insurance
business to a broad-based Insurance and Financial Services Group. UAP Group has
grown into a Pan-African Financial Services Group with a geographical footprint
in six (6) countries namely Kenya, Uganda, South Sudan, Rwanda, Tanzania and
Democratic Republic of Congo (DRC). The range of services and products have
grown beyond General Insurance to include Life Assurance, Property Investments,
Fund Management and related Financial Services such as insurance premium
financing, financial advisory and securities brokerage.
Job Summary: The Medical
Claims Manager will ensure control and overseer the medical claims processes
and procedures through use of effective techniques to achieve the objectives of
claims cost control, operational efficiency and meeting of the customer service
charter in claims payment.
Key Duties and Responsibilities: 
·        
Management of the claims process flows to ensure
efficiency in processing of claims as per the company medical claims procedure
manuals
·        
In charge of the verification and audit of
outpatient and inpatient claims as per the claims manual and customer service
charter manual to ensure compliance and mitigate risk.
·        
Negotiate professional fees and hospital charges
including discounts to control expenditure.
·        
The incumbent will manage the processing, settlement
of all claims and authorize requisitions.
·        
Holding regular business meetings with service
providers to ensure compliance on contract terms, use of agreed systems and
agreed tariffs.
·        
Actively monitor, prevent and control medical claims
fraud by carrying out regular audits on the internal and external systems/
processes as well as providers.
·        
Supervise, train and mentor medical claims staff to
achieve a high level of motivation and productivity by the team.
·        
Prepare regular claims reports to clients,
management and advice underwriter health on relevant claims findings for
medical risk review.
Qualifications, Skills and
Experience: 
·        
The applicant should hold a good Bachelor’s degree
qualification preferably in Nursing.
·        
Possession of a Diploma in Insurance and or a degree
in Health systems Management/ Business management will be an added advantage
·        
A minimum of two years’ experience in clinical
setting
·        
Three years’ experience working as a claims team
leader in a busy insurance environment
·        
Excellent communication and negotiation skills.
·        
Possess excellent public relations and interpersonal
relationship skills.
·        
Extensive networking with SP and other medical
insurers
·        
Excellent analytical and monitoring skills
·        
User IT skills in database management and office
systems.
·        
Ability to evaluate decisions made in benefit
utilization management.
·        
High degree of integrity and honesty
How to Apply:
All candidates
who wish to join the Insurance industry should send their applications via
Email with an updated CV and cover letter with the subject head as Claims
Manager to: hr@uap.co.ug.
Deadline: Friday, 23rd
October, 2015 by 5PM

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