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Penda Health
CLOSEDMedical Billing Associate
Nairobi, Kenya
Premier Hospital
CLOSEDAccounts Assistant
Nairobi, Kenya
The Lions SightFirst Eye Hospital
CLOSEDBilling / Dispatch Officer
Nairobi, Kenya
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Nairobi Adventist Hospital
CLOSEDClaims And Billing Officer
Nairobi, Kenya
Closing: May 2, 2024
This position has expiredPublished: Apr 29, 2024 (7 days ago)
Job Requirements
Education:
Work experience:
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Job Summary
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Key requirements and attributes
- Be a Clinical Officer at Penda.
- 1 year working experience at Penda.
- A great champion of Penda Way demonstrating strong leadership skills.
- A track record of great performance across all areas from the PR.
Responsibilities
Key requirements and attributes
- Be a Clinical Officer at Penda.
- 1 year working experience at Penda.
- A great champion of Penda Way demonstrating strong leadership skills.
- A track record of great performance across all areas from the PR.
- Thoroughly review claims for errors, accuracy, and completeness, rectifying any issues before submission to insurance companies. Provide direct feedback to medical centers/providers on identified errors.
- Coordinate pre-authorization and eligibility verification processes, ensuring compliance with insurance guidelines. Train medical center staff on insurance guidelines and provide consultation for compliance.
- Ensure timely dissemination of changes and communications from insurance partners to all medical centers. Maintain accurate record-keeping of invoices and communicate limits/exclusions to service points based on insurance guidelines.
- Support medical centers by identifying capacity gaps and providing training in medical billing. Liaise with the credit team to review disputed claims and provide clinical justification for appeals to insurance.
- Professionally respond to queries from insurance partners or medical centers regarding billing. Timely circulate memos to clinicians and clinical coordinators on new insurance guidelines.
- Scrutinize rejected claims related to clinical issues, providing guidance and coaching to medical centers to minimize claim denials. Submit invoices through designated portals for processing.
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