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Medical Accounting Associate

Closing: Nov 18, 2022

This position has expired

Published: Nov 4, 2022 (29 days ago)

Job Requirements

Education:

Work experience:

Language skills:

Job Summary

Contract Type:

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Job Purpose:

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

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.


Responsibilities

Job Purpose:

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

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.


Key responsibilities.

1. Payments and Reconciliation

  • Prepare monthly hospital payout targets for major providers and send the list to the Medical Claims Team
  • Generate and send remittance advice for payments made to the respective medical providers including the invoice details. 
  •  Review payouts on a regular basis with an aim of ensuring that monthly payout targets for major providers are met.
  • Perform reconciliations with provider statements and ensure resolution of outstanding balances on a timely basis.
  • Reconcile Britam Credit account facilities with the various providers and ensure the same is maintained within the agreed SLAs.
  • Monitor medical provider guarantees to ensure timely renewal of expired guarantees and cancellations for discontinued providers.

2. 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 to 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 the policy. 
  • Process medical premium refunds to clients

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