Claims Representative (GEH) - Provider Service Organisation

CLAIMS REPRESENTATIVE (GEH) - PROVIDER SERVICE ORGANISATION About Sokify Sokify is Kenya's leading online marketplace, connecting buyers and sellers across the nation. We're committed to delivering exceptional service and building trust in the digital commerce space. THE ROLE As a Claims Representative within our Provider Service Organisation, you'll be the backbone of our claims processing operation. This is an entry-level position ideal for someone eager to launch a career in professional claims administration. You'll handle a variety of technical, administrative, and operational claims tasks, working with both paper and electronic submissions from healthcare providers. Your day-to-day responsibilities include data entry, file maintenance, and providing essential support to our claims team, all under clear direction and close guidance. YOUR KEY RESPONSIBILITIES Process and adjudicate international medical, dental, and vision claims in accordance with policy terms and conditions, consistently meeting both personal productivity targets and team quality standards. Identify and monitor high-cost claims, ensuring relevant stakeholders are promptly informed of significant cases. Track claim turnaround times against service level agreements, escalating to your supervisor when timelines are at risk of being missed. Respond to provider enquiries regarding plan design, eligibility, and claims status within committed timeframes, working toward first-contact resolution wherever possible. Build effective working relationships with both internal colleagues and external customers to resolve provider-related issues efficiently. Take full ownership of your assigned Provider Country Cluster. Spot opportunities for process enhancements and share recommendations with senior team members. Support colleagues actively and contribute your effort to achieving wider team objectives. Collaborate across the European business as operational needs require. Complete additional tasks as they arise to support business priorities. WHO YOU ARE You're customer-focused with a natural ability to identify and resolve problems. You excel at meeting or exceeding targets while juggling multiple priorities simultaneously. You're comfortable using Microsoft Office applications and ideally hold English and Arithmetic qualifications. While experience in medical administration, claims processing, or customer service environments is a bonus, it's not a deal-breaker if you don't have it yet. WHAT WE'RE LOOKING FOR Exceptional attention to detail with consistently high accuracy in your work. Strong interpersonal abilities with clear, professional communication skills both verbally and in writing. A genuine customer-first mindset combined with problem-solving capability. The drive to work independently and actively suggest ways to improve processes. Strong organisational and prioritisation skills that help you manage workflows effectively. Sound judgement in handling day-to-day decisions. EQUAL OPPORTUNITIES Sokify considers all qualified applicants for employment without regard to race, colour, age, disability, sex, sexual orientation, gender identity, veteran status, religion, national origin, ancestry, marital or familial status, genetic information, citizenship status, or any other legally protected characteristic.