Claims and Billing Officer at Nairobi Adventist Hospital

Job Purpose

The main purpose of the job is to provide correct billing for patients under cash, insurance and NHIF cover in an accurate and timely manner.

Key duties and responsibilities

• Prepare billing statements for insurance companies, cash and corporate patients and other third parties
• Review the discharge sheets for accuracy and completion to prepare billing statements
• Analyze invoices and data, prepare reports and respond to inquiries concerning billing activities
• Ensure pre-authorizations are done for corporate and NHIF clients
• Verify NHIF status and approvals and ensure biometrics capture as per procedure
• Update patients’ bills daily in coordination with other billing points within the hospital and other external partners
• Ensure that all services offered are billed/invoiced
• Update the corporate and cash payers on their bills daily or on-demand
• Carry out daily routine ward rounds to collect billing information and update the clients and patients
• Check insurance/corporate/ NHIF documents for authenticity and validity
• Establish payment arrangements with patients; monitor payments; following up with patients when payment lapses occur
• Discharge clients by processing their bills and issuing gate passes
• Prepare daily, weekly and monthly billing reports
• Post/process bills in the correct and relevant accounts in the system
• Prepare the physical corporate / NHIF invoices-claims and attach the relevant documents for dispatch within the agreed credit period
• Participate in stock take exercises
• Ensure safe custody of all documents/LOUs /Guarantee of Payments used in discharging Corporate clients
• Serve and protect the hospital’s image by adhering to professional standards, hospital policies and procedures
• Any other responsibility assigned to the jobholder by the supervisor from time to time
• Follow up with insurance companies, NHIF and other corporate players for timely payment of claims
• ETIMS: entering all corporate invoices in ETIMS, generating all receipts and filling them according to receipt number

Qualifications

• Degree or Diploma in Business Administration, Economics, Finance or other business-related fields from a recognized institution.
• Partial accounting qualification, i.e. CPA Part II or ACCA 2.
• Minimum of 4 years’ experience, with two years in a billing function
• Must have experience in processing NHIF and insurance claims

Competencies

• Computer literacy,
• Accounting skills
• Attention to detail
• Customer relation skills
• Communication skills
• Negotiating skills