Job Detail

Job Description

Job Ref. No: JHIL082
We currently have an exciting career opportunity for a Quality Assurance Officer within Jubilee Health Insurance Limited. The position holder will report to the Assistant Manager – Quality Assurance and will be based at our Head Office in Nairobi.

Role Purpose
Under general supervision, the role holder is responsible for performing intermediate and daily quality assurance reviews to ensure and report on the accuracy of claims processing end-to-end and other key business processes.

Main Responsibilities
Operational

• Periodically and methodically audit medical claim transactions, including high value claims.
• Determine error sources and give recommendations for resolving.
• Ensure pricing arrangements have been applied accurately.
• Analyze claims’ supporting documents to establish validity and liability.
• Monitor key interfaces and ensure that they adhere to the set claims-handling standards and escalate non- adherence to management.

Corporate Governance

• Ensure compliance with company policies, procedures, and regulatory guidelines.
• Maintain confidentiality and handle sensitive information in accordance with privacy laws and regulations.
• Adhere to ethical standards and maintain professional conduct while dealing with confidential or sensitive matters.

Culture

• Engaging in ongoing professional development activities to enhance knowledge and skills in quality assurance, regulatory compliance, and corporate governance.
• Foster effective working relationships with internal stakeholders.
• Foster a culture of accountability and responsibility within the quality assurance function.
• Serve as a role model for exceptional customer service and professionalism.
• Change Management: Assist in driving change initiatives within the quality assurance team and the broader organization. Help team members adapt to changes and foster a culture of agility and continuous improvement.

Key Competencies

• Detail-oriented with problem-solving abilities, structural and conceptual thinking.
• Ability to handle detailed tasks and work with varying types of data.
• Ability to maintain confidentiality.
• A team player willing to learn, apply and improve Quality Assurance best practices consistently.

Qualifications

• Bachelor’s degree in any Healthcare related field.
• Proficiency in data analysis using MS Excel or other advanced tools is an added advantage.
• Professional qualification in Insurance (ACII, AIIK) is an added advantage.
• Knowledge of medical insurance claims processes and procedures.
• Knowledge and experience in clinical settings.
• Knowledge and experience in the insurance concepts & regulatory requirements.

Relevant Experience

• 3 years’ experience in customer service or quality assurance in the insurance industry.

If you are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com quoting the Job Reference Number and Position by 24th July 2023. Only shortlisted candidates will be contacted.

To Apply:
https://jubileeinsurance.com/ke/wp-content/uploads/2023/07/JHIL082-QUALITY-ASSURANCE-OFFICER.pdf