Background information about the job or company (e.g., role context, company overview)

Libertas General Insurance Company Limited Applications are invited from suitably qualified and experienced people to fill the following position tenable at our head office in Blantyre.

Job Purpose

To manage medical insurance claims and Healthcare provider accounts efficiently and accurately, ensuring compliance with company policies, regulatory requirements, service standards and service level agreement.

Qualifications or requirements (e.g., education, skills)

• Bachelor’s degree in healthcare management, Nursing, Business Administration, or related field.
• Professional certificate in insurance & experience in medical insurance claim handling is an added advantage.
• Strong knowledge of medical terminology and healthcare procedures.
• Familiarity with insurance regulations and claims processing systems.
• Analytical and problem-solving skills.
• Excellent communication and negotiation abilities.
• Attention to detail and accuracy.
• Ability to work under pressure and meet deadlines.

Experience needed

2–4 years’ experience in health insurance claims processing or a related role. Exposure to risk management and fraud detection is desirable.

• Claims Assessment: Review and verify submitted medical claims for completeness, accuracy, and eligibility under policy terms.
• Documentation & Verification: Ensure all supporting documents (medical reports, invoices, prescriptions, proof of payments) are authentic and meet policy requirements.
• Fraud Detection: Identify potential fraudulent claims and escalate for investigation.
• Customer Service: Communicate with policyholders, healthcare providers, and internal teams to resolve queries and provide claim status updates.
• Compliance: Adhere to regulatory guidelines and company policies in claims processing.
• Reporting: Maintain accurate records and prepare weekly, monthly, quarterly and other periodic reports on claims trends and performance.
• Collaboration: Work closely with underwriting, case management, finance, Key accounts personnel and risk management teams to ensure smooth operations.
• Payments and Reconciliation: Audit and process claims and ensure all provider /member payments are made accurately and as per SLA.
• Account reconciliation: To reconcile all accounts and always keep them up to date.
• Supervision: Directly plan and supervise the work of Claim administrators.

• Strong knowledge of medical terminology and healthcare procedures.
• Familiarity with insurance regulations and claims processing systems.
• Analytical and problem-solving skills.
• Excellent communication and negotiation abilities.
• Attention to detail and accuracy.
• Ability to work under pressure and meet deadlines.

• Bachelor’s degree in healthcare management, Nursing, Business Administration, or related field.
• Professional certificate in insurance & experience in medical insurance claim handling is an added advantage.