Medical Accounting Associate at Britam

Job Purpose:

The role holder will be responsible for Medical Accounting including; Fund management, general ledger reconciliations, premium collections, provider reconciliations and ensuring that provider payments are made on time.

Key responsibilities:

Payments and Reconciliation.

• Prepare monthly hospital pay out targets for major providers and send the list to Medical Claims Team. 
• Generate and send remittance advises for payments made to the respective medical providers including with the invoice details. 
• Review pay outs on a regular basis with an aim of ensuring that monthly pay out targets for major providers are met.
• Perform reconciliations with provider statements, ensure resolution of outstanding balances on a timely basis and obtain clearance letters from providers.
• Reconcile Britam Credit account facilities with the various providers and ensure the same are maintained within the agreed SLAs.
• Monitor medical provider guarantees ensuring timely renewal of expired guarantees and cancellations for discontinued providers.
• Delegated Authority:  As per the approved Delegated Authority Matrix.

Fund & Insured Schemes Management.

• Monitor utilization of funded schemes and follow up on replenishment at 75% utilization.
• Generate and issue monthly fund utilization statements and Insured schemes on request.
• Advise cashier on the receipting and allocation for all medical collections including; Insured premiums, Funded schemes and card costs.
• Perform monthly reconciliation of funded schemes and agree balances to ERP General Ledger Out Patient fund account. 
• Generate Insured premium statement and facilitate collection of the same with the Sales team and intermediaries.
• Reconciliation and collection/recovery of medical claims paid outside policy. 
• Process medical premium refunds to clients.

General Ledger Reconciliations.

• Prepare monthly reconciliation of general ledgers assigned and pass any adjusting entries to ensure accuracy of amounts reported.

Key Performance Measures:

As described in your Personal Score Card

Knowledge, experience and qualifications required:

• Bachelor's degree in a business related field.
• CPA(K) or other similarly recognized accounting profession qualification.
• 2-3 years of accounting experience in a similar role.
• Knowledge of ERP AP system and/or experience of using Oracle Financials would be an advantage.
• Strong  computer and business solutions software skills.
• Strong analytical and problem solving skills.
• Analytical skills.

Technical/ Functional competencies:

• Knowledge of insurance regulatory requirements.
• Knowledge of insurance products.
• Sales and marketing management skills.

Leadership category responsibility framework (Core Competencies):

Emerging Leaders Competency Descriptions.

• Presenting and Communicating Information - Speaks fluently; expresses opinions, information and key points of an argument clearly; presents effectively; responds quickly to others ‘reactions and feedback during conversations; projects credibility.
• Working with People - Shows respect for the views and contributions of team members; shows empathy; listens, supports and cares for others; consults others and pro-actively shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
• Adhering to Principles and Values - Upholds and encourages ethical behaviour and departmental values; demonstrates integrity; encourages individual responsibility towards the community and the environment; models the organizational values during every day interactions.
• Analyzing - Analyses numerical data and all other sources of information, breaking them into component parts, patterns and relationships; probes for further information or greater understanding of a problem; makes rational judgments from the available information and analysis; demonstrates an understanding of how one issue may be part of a much larger system / process / problem.
• Planning and Organizing - Adheres to and monitors clearly defined objectives; plans activities and projects well in advance and takes account of possible changing circumstances; identifies and organizes resources needed to accomplish tasks; manages time effectively; monitors performance against deadlines and milestones.
• Delivering Results and Meeting Customer Expectations - Focuses on customer needs and satisfaction; sets and models high standards for quality and quantity; monitors and maintains quality and productivity; works in a systematic methodical and orderly way; consistently achieves projects goals.
• Deciding and Initiating Action - Takes responsibility for own, as well as subordinates’ actions and projects; takes initiative and works under own direction; initiates and generates activity; introduces improvements into work processes; handles problems with minimal guidance.
• Leading and Supervising - Provides subordinates with a clear direction; motivates and empowers others; provides subordinates with the relevant coaching; creates a positive climate that fosters learning and development; identifies high potential talent; sets and articulates the departmental vision and values through own personal behaviour; sets appropriate standards of behaviour.
• Formulating Strategies and Concepts - Works strategically to realize personal goals; understands and effectively communicates the departmental strategy; translates the departmental strategy and vision into operational responsibilities; takes into consideration departmental strategy during all tasks; takes account of a wide range of issues across, and related to current role.
• Applying Expertise and Technology - Applies specialist and detailed technical expertise; uses technology to achieve work objectives; develops job knowledge and expertise (theoretical and practical) through continual professional development; demonstrates an understanding of different organizational departments and functions.
• Following Instructions and Procedures - Challenges authority only when appropriate; follows procedures and policies; keeps to schedules; arrives punctually for work and meetings; demonstrates a commitment to the organization; complies with legal obligations and safety requirements of the role.
• Adapting and Responding to change - Adapts to changing circumstances; tolerates ambiguity; accepts new ideas and change initiatives; adapts interpersonal style to suit different people or situations; shows an interest in new experiences.

Closing: 18-11-2022