Claims Officer at Marie Stopes Tanzania (MST) September, 2023

Job Title: Claims Officer

Marie Stopes Tanzania (MST)

CAREER OPPORTUNITIES

Marie Stopes Tanzania (MST), a Non-Governmental Organization, is a social enterprise and a leading provider of family planning, sexual and reproductive health care, and allied services. MST is a partner of the Government of Tanzania and a member of the Marie Stopes International (MSI) Global Partnership, which operates in over 37 countries worldwide. MST is committed to its employees, clients, children, and vulnerable adults’ protection, and has zero tolerance to any sort of harassment. MST promotes a speaking up culture whereby employees work transparently and are empowered to report any existence or potential existence of harassment at workplaces.

MST’s mission is that all women and men in Tanzania will have “Children by Choice, Not Chance”.

As an equal opportunity Employer, MST is looking for active and qualified individuals for the following roles:

Job Pupose:

Reporting to Hospital Manager, the Claims Officer, as a key member of our organization, will play a crucial role in supporting the growth and sustainability of our hospital and clinics business operations. Your primary responsibilities will be reconciling insurance claims by validating the information in the medical claim forms and to provide comprehensive support to the hospital and clinics by conducting market research, assisting in fundraising efforts and proposal development, coordinating partnerships, and promoting our healthcare services to ensure the delivery of quality healthcare to the clients. The incumbent may be required to travel within Tanzania to support the clinics.

Among the Key Responsibilities:

  1. Managing corporate clients for proper management of claims:
    • Working closely with Center Managers to improve filing of insurance claims.
    • Communicating timely with insured clients in case there is misunderstanding between a client and insurance.
    • Working closely with receptionists to ensure all insured clients are checked properly before services.
    • Preparing daily bill reconciliation, monthly and annual reports.
    • Screening daily/monthly claim forms from Marie Stopes Tanzania centers.
    • Recording transaction properly in the E.H.R.
    • Learning and keeping up to date the MST products and services with changes.
    • Maintaining MST policies and standards for customer care.
    • Supervising closely the receptionist and clinicians on claims compliance based on the corporates contract agreement.
  1. Preparing and issuing corporate client invoices:
    • Making sure every corporate client receives a copy of claim form.
    • Verifying the prices charged on claim form agreed to the MST price list.
    • Informing bill client of total cost of services.

3. Marketing and demand generation:

4. Customer Care:

  • Treating clients always with much respect.
  • Providing information in a good way with regards to ethics of organization and customer service.
  • Providing training and education about insurance exclusions (service covered and not covered by insurance) to clients and staff.
  • Solving challenges which face clients.

Minimum Requirements:

Qualifications:

  • First degree graduate in Insurance, Business Administration, or related courses.
  • Desirable: management and leadership skills, computer illiteracy, dealing with customers and staff challenges in a good way.

Experience:

  • 3- year experience of working in medical insurance and health organization with strong administrative skills and experience.
  • Sound experience working with medical insurance(s) in Tanzania including with the Tanzanian Health systems.

Skills:

  • Attention to details, solving clients’ cases and strategies to raise income.
  • Good knowledge on claims electronic systems and hospital information systems.
  • Personal credibility.
  • Ability to prioritise.
  • Good interpersonal skills with the ability to communicate at all levels and good customer care.
  • Good communication skills, fluent in English & Kiswahili both verbal & written.

Mode of Application:

If you feel that you are able to meet the requirements, and you are motivated enough to be part of the team, please send your application CV and cover letter by email detailing your suitability and why you are interested in the post, to the address below:

Director of Human Resources and Administration

Marie Stopes Tanzania

Plot 421 & 422 Mwenge | Kijitonyama area P.O. Box 7072, Dar es Salaam | Tanzania.

Telephone: +255 22 2774991-4, +255 22 2702030-2

E-mail: jobs@mst.or.tz

Closing date: All applications should reach the addressee before October 16, 2023. Only short- listed candidates will be contacted.