Job Summary
Applications are invited from qualified persons for the above vacant position.
Minimum Qualification:Bachelor
Experience Level:Senior level
Experience Length:5 years
Job Description
LifeCare Hospitals Ltd is a group of hospitals built on strong knowledge, experience and highly skilled medical foundation. We are committed to providing first class health care of international standards to all individuals within the local and extended areas. LifeCare Hospitals Ltd is an emerging high-end health care service delivery provider in Kenya. LifeCare Hospitals Bungoma, a level 5 referral 100+ bed capacity is a fully operational hospital. Our various State-of-art hospitals in Migori, Nairobi and Mombasa are under way.
Deputy Manager – Claims LifeCare Hospitals Bungoma
Reporting to the Senior Finance -Manager the successful candidate will be responsible for the following amongst others:
Main Duties
• Responsible for verification and validation of insurance claims process in the Hospital
• Maintaining high standards in claims service environment especially on data entry, claims registers and both internal and external communication standards.
• Checking different types of information for accuracy with an aim of making a fair judgment on claims validation process.
• Analyzing claims and decide whether they are covered as per the policy.
• Informing clients if claims are accepted and how they will be allocated and making recommendations for the settlement of patient claims.
• Ensuring that claims process is effective and efficiently executed as per the set standards of the claims process and making sure all enquiries and payments are dealt with quickly.
• Daily reviewing of previous day’s admissions, discharges and OPD bills before claiming.
• Daily reviewing of all preauthorization before upload on NHIF portal.
• Daily reporting to management on outstanding issues, whilst highlighting potential claim problems.
• Coordinating all medical issues with Medical Officers, Consultants and Medical Superintendent for further resolution.
• Meeting medical team at least once monthly to create awareness and to highlight corrective measures.
• Manage IP and OP claims by ensuring the timeliness and accuracy of billings and claims processing upon functional standards.
• Understanding insurance billing contracts, agreements and responsibilities.
• Collaborating with team members to facilitate the delivery of effective billing services and follow-up to all insurance customers to promote account reconciliation.
• Resolving incoming queries on billing or outstanding accounts from patients, insurance companies, consultants or colleagues in a professional and efficient manner.
• Providing correct information with regard to fees, excesses or co-payments on individual policies or individual procedures.
• Participating in all audits, service evaluations and process reviews to enhance the collection of outstanding payments.
• Creating an environment that encourages teamwork, positive attitude and high morale.
• Participating in preparation of shift roster/ ROTA to help provide the required cover in Claims and IP billing departments.
• Escalating problem insurance accounts/high balance owing accounts as applicable to the Manager- Finance.
• Developing, facilitating and maintaining efficient admission, discharge and transfer procedures.
• Ensuring monthly and year end processing deadlines are met as required.
• Championing customer service excellence and continual improvement.
• Any other role that you may be called upon to perform from time to time.
Qualifications and skills
• Diploma in Clinical Medicine from a recognized institution
• B. Com of Commerce degree majoring in Accounting or its equivalent is an added advantage
• The position requires active knowledge in health care practise and attention to detail.
• 5 years’ working experience with at least (2) at the same role.
• Expert knowledge in credit management.
• Strong leadership skills.
• Sound problem solving and decision making skills.
• Refined customer service skills.
• Excellent negotiations skills
If your background, experience and competence match the above specifications, please send us your application quoting the reference and include your current remuneration, testimonials and full contact details of 3 referees to: To be received not later than15th November 2020. Only shortlisted candidates will be contacted.
Important Safety Tips
1. Do not make any payment without confirming with the BrighterMonday Customer Support Team.
2. If you think this advert is not genuine, please report it via the Report Job link below.
