Entitlement Officer - Clinical, Debtors Department at Aga Khan University

Nairobi, , Kenya -

Full Time

Start Date

Immediate

Expiry Date

03 May, 26

Salary

0.0

Posted On

02 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Background, Billing Management, Claims Vetting, Customer Service, Communication Skills, Interpersonal Skills, MS Office Suite, Accounting, Credit Management, Clinical Practice, Report Maintenance, Continuous Education, Problem Solving, Team Collaboration, Time Management, Attention to Detail

Industry

Hospitals and Health Care

Description

Debtors, Finance Division Entity Aga Khan University Hospital, Nairobi Location Nairobi, Kenya Introduction Aga Khan University Hospital, Nairobi is a private not-for-profit teaching hospital that provides tertiary and secondary level healthcare services. It is the first hospital in East Africa to be accredited by the Joint Commission International from the USA. The University Hospital has been providing high quality care for the people of East Africa and beyond for over 60 years. Under The Aga Khan University Hospital is an Outreach Division, which is a rapidly growing network of about 50 medical centers spread over East Africa. These medical centers feature three to five consulting rooms with a practice that is home to specialists, qualified medical officers, highly experienced nurses and constant reception cover. The clinics offer an on-site pharmacy and laboratory as well as imaging services. There is high expectation for staff to provide high quality professional services. Applications are invited from appropriately qualified candidates with a clinical background for the position of Entitlement officer in the Debtors Section, Finance Division. Position Summary Reporting to the Supervisor Corporate Entitlement, the Entitlement Officer will assist the Supervisor in the management of billing corporate guidelines (Entitlements) by ensuring correct and accurate mapping in the system. Claims vetting before dispatch and analysis of rejected claims to minimize the level of bad debts. Key Responsibilities: · 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. 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.

Responsibilities

The Entitlement Officer will assist in managing billing corporate guidelines and ensure accurate mapping in the system. Responsibilities include claims vetting, monitoring invoice returns, and organizing meetings with corporate clients.