Claims Management Officer at St. Theresa’s Mission Hospital

Job Summary: The main purpose of the job is to authenticate billings for patients under cash, insurance and NHIF cover in an accurate and timely manner for claims processing.

Job Specifications/Qualification

• Degree or Diploma in Nursing/Clinical Medicine from a recognized institution
• Proficiency in use Health Management Information Systems
• Computer Literacy (Microsoft packages)
• Previous experience in quality assurance will be an added advantage

Job Description

• Patient registration, documentation and the formalities (documents/forms required at every stage by the insurance companies
• Understanding on general practice the procedures and care and the period of stay as well as standard equipment and drugs
• Audit of real time procedures as well as the completeness of documentation of the completed procedures
• 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
• Follow up with insurance companies, NHIF and other corporate players for timely payment of claims
• 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
• Check insurance/corporate/ NHIF documents for authenticity and validity
• To perform any other duties as assigned by the management