Accounting, finance, banking, insurance Jobs for Entry and Basic-level in Africa

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M.P Shah Hospital

Claims Processing Officer

Nairobi Kenya

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Cigna

Billing Analyst Africa Business

Nairobi Kenya
Closed for applications
M.P Shah Hospital

Health care + 1 more

Claims Processing Officer

Job details

Contract Type

Description

Education

  • Diploma or Higher Diploma in business-related field
  • Years’ experience in a Finance and /or accounting position.
  • Accounting Knowledge has an added advantage

Key performance Indicators

  • Dispatch TAT for invoices. Inpatient – 24 hours and outpatient – 48 hours.
  • Ensure the rejections rate should be below 1%
  • Ensure 100% compliance with Invoices Vetting SOPs
  • Ensure all invoices are received within 24 hours


Responsibilities
  • Strengthen transparency and accountability in the claims processing process by managing all in-patient and out-patient invoices in a professional manner that offers an accurate reflection of all invoiced services. Ensure Minimal Rejection Rate by ensuring all complete set of documents are delivered whether online or physically as per client policies. Ensure all rejections are worked on within 5 working days from date of receipt.
  • Maintain the validity and accuracy of the hospital’s records by following up as is necessary for any incomplete documents received at the dispatch department and reviewing them to highlight any discrepancies captured on all documentations received. Maintain all documents sent to clients as per Hospital policies
  • Facilitate productive engagement with corporate clients by ensuring all claims are delivered accordingly, promptly as per corporate policies and all queries are resolved to promote client satisfaction.
  • Maintain client confidence and foster a culture of accountability by assisting in the retrieval of proof of deliveries when needed and working with the utmost degree of integrity and confidentiality within the set compliance framework.
  • Reporting: Ensure that all necessary reports are prepared and sent to the relevant parties on time as per agreed timelines.
  • Developing self and others. Drive continuous development of self and colleagues in the organization by enrolling in career and personal development courses/ programme, actively sharing lessons and insights with the rest of the team from personal experiences, and engaging with the line manager regularly for feedback on performance.


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