Risk Assessor (CIMFAD) 12.2025

Zimbabwe·Hararemid

OtherRisk

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Quick Summary

Overview

The main responsibilities of the job are: Reviewing claims to identify errors, fraud, and trends. Pre-authorizing hospital admissions and monitoring member benefits. Registering and following up with patients enrolled in the chronic disease management program.

Requirements Summary

Diploma in Nursing Degree in Nursing is an added advantage. Insurance and Risk Management qualification is an added advantage. Diploma in Theatre Nursing and/or Midwifery is an added advantage.

Technical Tools

OtherRisk

Responsibilities

~1 min read

Reviewing claims to identify errors, fraud, and trends.
Pre-authorizing hospital admissions and monitoring member benefits.
Registering and following up with patients enrolled in the chronic disease management program.
Conducting workplace-based wellness programs for corporate clients.
Investigating service providers and members with suspicious claiming patterns.

Requirements

~1 min read

Diploma in Nursing
Degree in Nursing is an added advantage.
Insurance and Risk Management qualification is an added advantage.
Diploma in Theatre Nursing and/or Midwifery is an added advantage.

Have at least 2 years’ experience in claims investigations, case management, and implementation of wellness programmes within a medical aid environment.
Possess excellent investigative, problem-solving, and decision-making skills.
Demonstrate a strong client focus.
Have good written and verbal communication skills.
Be a person of integrity, with the ability to handle sensitive information confidentially and transparently.