Entitlement Officer - Clinical, Debtors Department

Qualifications and skills required:

• Diploma in Nursing, Pharmacy, or a related clinical field.
  
• Kenya Certificate of Secondary Education (KCSE) with mean grade C or its equivalent
  
• Proficient in MS Office Suite
  
• Formal training in customer care or equivalent demonstrated experience.
  
• A minimum of 1 (one) year experience in a busy claim vetting and assessment department
  
• A minimum of 1 (one) year exposure in clinical practice.
  
• A minimum of 3 (three) years’ experience in a busy accounting/credit management department
  
• Excellent communication skills, both written and oral
  
• Excellent customer service skills
  
• Good interpersonal skills: Ability to build relationships among team members
  
• Ability to work under pressure and meet stringent deadlines.
  

• To offer prompt and satisfactory services to internal and external clients as per the established policies and procedures of the department to enable overall accomplishment of the departmental goals
  
• Participate in ensuring that all the billing points are updated on new / closed accounts, corporate clients’ administration guidelines on timely basis and they adhere to the same
  
• Opening/closing of accounts as advised by relevant corporate clients and in line with the hospital guidelines on the same
  
• Assisting in monitoring invoice returns and taking appropriate action on clinical queries as per the set deadline
  
• To assist in organizing and holding meetings with corporate clients to discuss status of their accounts regarding entitlements, exclusions and returned invoices and overall clinical reconciliation sign off
  
• Participate in Continuous Entitlements Education (CEE) for Clinical and non -clinical areas for excellent service delivery
  
• Assist in the coordination of renewal of corporate agreements and fulfillment of terms of the administration rules and guidelines from corporate clients
  
• Maintenance of timely and accurate departmental reports e.g., accounts opened/closed, rejection rate, individual corporate performance, copay schedules, CME meeting minutes
  
• Participate in preparation of all Institution and Financial audits to enable the Department to achieve its quality objectives
  
• Report any incidents regarding corporate credit management to the Supervisor
  
• Assist in the maintenance and monitoring of Master Register of Corporate accounts from inception to expiry timelines in order to hedge against provision of services to expired accounts.
  
• Continuous monitoring of hospital and outreach billing to ensure all claims comply with corporate requirement including but not limited to ensuring e-diagnosis is captured.