Employer: Mfuko wa Taifa wa Bima ya Afya (NHIF)
Date Published: 2018-03-05
Application Deadline: 2018-03-19
Application Deadline: 2018-03-19
JOB SUMMARY:
N/A
DUTIES AND RESPONSIBILITIES:
i. Receiving and verifying all claim forms;
ii. Processing, verification and checking of claims and prescriptions in
ensuring adherence to stipulated standards;
iii. Attending and addressing members enquiries and complaints;
iv. Visiting and scrutinize all admitted patients in the facility;
v. Collecting and approving patient over stay for admitted clients in
respective facility;
vi. Informing on any misconduct noted at respective facilities or any
salient findings;
vii. Advise the Fund on various issues related to improvement in
claim processing, quality improvement and curbing fraud;
viii. Preparing and submitting periodic work reports to the supervisor;
ix. Performing necessary quality assurance activities at the facility;
and
x. Performing any other related duties as may be assigned by the
supervisor.
ii. Processing, verification and checking of claims and prescriptions in
ensuring adherence to stipulated standards;
iii. Attending and addressing members enquiries and complaints;
iv. Visiting and scrutinize all admitted patients in the facility;
v. Collecting and approving patient over stay for admitted clients in
respective facility;
vi. Informing on any misconduct noted at respective facilities or any
salient findings;
vii. Advise the Fund on various issues related to improvement in
claim processing, quality improvement and curbing fraud;
viii. Preparing and submitting periodic work reports to the supervisor;
ix. Performing necessary quality assurance activities at the facility;
and
x. Performing any other related duties as may be assigned by the
supervisor.
QUALIFICATION AND EXPERIENCE:
Degree in clinical Medicine from a recognized University or Institution,
Licensed Medical Practitioner Certificate from Medical Council of
Tanganyika or Medical Council of Zanzibar. Experience in working in
tertiary hospital levels (Regional, Zonal and National) and other
analyzed criteria in performing Quality assurance duties (claims
management, health advocacy and information management). At least
two years working experience in clinical medicine and should be
computer literate (MS Word and excel) and capable of utilizing approved
Fund’s electronic systems in claims management, approval of services
and membership management
Licensed Medical Practitioner Certificate from Medical Council of
Tanganyika or Medical Council of Zanzibar. Experience in working in
tertiary hospital levels (Regional, Zonal and National) and other
analyzed criteria in performing Quality assurance duties (claims
management, health advocacy and information management). At least
two years working experience in clinical medicine and should be
computer literate (MS Word and excel) and capable of utilizing approved
Fund’s electronic systems in claims management, approval of services
and membership management
REMUNERATION: Salary Scale NHIF SCALE
Driver job, Driver job, home from work, Driver job, get paid, Driver job