Junior Claims Assessor – 3-Month Temporary Contract (Nairobi, Hybrid)

Junior Claims Assessor – 3-Month Temporary Contract (Nairobi, Hybrid)

ESSENTIAL JOB DETAILS

• Position: Junior Claims Assessor
• Location: Nairobi (Hybrid)
• Type of Job: Temporary (3 months)
• Job Category: Customer Operations
• Reporting to: Customer Operations Department
• Application Deadline: Open until filled

INTRODUCTION

An exciting opportunity has opened for a Junior Claims Assessor to join a fast-growing international fintech company dedicated to transforming the healthcare insurance sector. This role is integral to ensuring that medical claims are vetted, analyzed, and reported effectively to enhance the efficiency of healthcare service delivery.

As part of the Customer Operations team, you will work in a dynamic, collaborative environment where your expertise in claim assessments, provider feedback, and data analysis will contribute directly to project objectives. The ideal candidate should have experience in medical claim processing, data analytics, and customer support.

If you have a background in nursing, medical claims assessment, or healthcare administration and are seeking a temporary role with a mission-driven organization, this opportunity is perfect for you.

ABOUT CAREPAY

CarePay is an innovative, international fintech company operating in Kenya, Nigeria, Tanzania, and the Netherlands. The company aims to make mobile health insurance accessible to all by leveraging technology to create a seamless digital healthcare payment system.

Using a smart payment distribution platform, CarePay connects patients, insurers, healthcare providers, and premium payers on one ecosystem, enhancing transparency, reducing costs, and increasing efficiency. With over 4.5 million participants and 1,200 healthcare facilities integrated into its network, CarePay is revolutionizing digital healthcare transactions.

Notably, CarePay has received global recognition, including:

• FT/IFC Transformational Business Award (2017)
• World Economic Forum’s Technology Pioneer Award (2018)
• Swiss Re Entrepreneurs for Resilience Award (2019)

KEY RESPONSIBILITIES

• Assess and verify all medical claims to ensure compliance with project objectives and payer requirements.
• Analyze claims data to identify trends, inconsistencies, and areas for process improvement.
• Provide feedback to healthcare providers when claims do not meet expectations, ensuring they receive clear, actionable guidance.
• Reassess re-submitted claims, confirming that queries have been addressed and compliance standards met.
• Support the customer call center by addressing escalated medical queries related to claims and benefits.
• Extract, document, and present data insights on provider practices, claim trends, and disease patterns.
• Deliver training sessions and feedback reports to stakeholders based on claims assessment findings.
• Map generic rules to medical services, procedures, drugs, and lab tests to enhance system efficiency.
• Participate in system testing and documentation, contributing to continuous platform improvement.
• Support case management processes to ensure smooth coordination between stakeholders.
• Perform other duties as assigned by the supervisor.

QUALIFICATIONS AND SKILLS

Educational Qualifications

• Degree/Diploma in Nursing, Medical Claims Assessment, or a related medical field.
• A strong understanding of private and public healthcare delivery systems.

Required Experience

• At least 2 years’ experience in a busy hospital setup or medical claims assessment role.
• Strong knowledge of medical treatment protocols and cost-effective prescribing habits.

Key Competencies

• Analytical and problem-solving skills with the ability to evaluate medical claims efficiently.
• Excellent communication skills, both oral and written.
• Strong interpersonal skills, with the ability to work with cross-cultural teams.
• Customer service skills to engage effectively with providers and insurers.
• Data entry skills, ensuring accurate and high-quality claims documentation.
• Attention to detail, with the ability to recognize inconsistencies in claims.
• Time management skills to meet deadlines and process claims promptly.
• Flexibility and adaptability, with the ability to work in high-pressure environments.
• Commitment to confidentiality and professional integrity.

COMPANY CULTURE AND VALUES

At CarePay, we foster a culture of collaboration, innovation, and integrity. Employees are encouraged to think creatively, solve complex healthcare challenges, and contribute to a mission-driven, impact-oriented work environment.

Key values include:

• Transparency and Accountability – Ensuring all transactions and claims assessments meet high ethical standards.
• Customer-Centricity – Prioritizing patient needs and service quality in all processes.
• Technological Innovation – Leveraging cutting-edge technology to improve healthcare accessibility and affordability.
• Diversity and Inclusion – Encouraging a supportive workplace where diverse perspectives thrive.

HOW TO APPLY

Interested candidates should submit their applications via the CarePay Careers Portal by filling out the application form and attaching a detailed CV and cover letter.

Apply Now for the Junior Claims Assessor Role

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