Job Openings at Aga Khan University Hospital

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 of 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 incidences 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 or equivalent
• 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) years’ experience in a busy claim vetting and assessment department
• A minimum of 1 (one) year’s 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.

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Position Summary:

Reporting to the Team Leader, Corporate, the Senior Accounts Clerk will ensure that all the corporate unallocated credits are maintained at the lowest possible level of the current benchmark and prepare accurate and timely debtors reports as per the agreed timings.

Key Responsibilities

• Reconcile corporate client accounts on monthly basis (two major accounts every month).
• Collect, verify and sort NHIF claims on daily basis as per NHIF requirements.
• Check all the accurate attachments are in order and stamp the claims. 
• Process claims through Meditech system and enclose them on a daily basis.
• Pass on journal vouchers for write offs and collection and billing errors.
• Process all pending claims/returns for the week on every Monday & 3rd of every month for the previous month.
• Highlight all discrepancies captured while processing NHIF claims with supervisor once encountered.
• Calculate approved discounts as per accounts corporate agreements and pass Journal entry.
• Generate report after daily NHIF claim/invoice dispatch and forward downloads for main account to Team leaders on daily basis.
• Liaise with Dispatch team and team Leaders to ensure that all invoices have been dispatched and received by corporate on weekly basis.
• Ensure accurate and complete NHIF claims with accompanying attachments are dispatched in a timely manner in NHIF System
• Organize and hold meetings with Dispatch team to discuss the invoice status of respective corporate in the dispatch reports.
• Reconcile People soft accounts as regularly allocated by the Supervisor i.e., Welfare, discounts, provisions, co-pay, maternity deposits/other deposits etc.
• Maintain confidentiality and safe custody of the Internal and External clients’ documents.
• Maintain timely and accurate departmental reports.
• Participate in preparation of service audits to enable the department to achieve its quality objective.
• Maintain all the records, correspondence for NHIF claim attachments, and corporate reconciliation.
• Deal with any enquiries that may arise as per stipulated policy guidelines
• Offer prompt and satisfactory services to internal and external clients as per the established policies and procedures of the department
• Receipt allocation of cheques received from corporate and individuals
• Ensure all payments from corporate and individual clients, adjusting entries and credit notes raised are reconciled to the respective debit entries as per the remittance advice provided by the clients
• Ensure that unallocated credits schedule is updated on a timely basis
• Any other duties as may be assigned by the supervisor.

Qualifications and skills required

• Bachelor of Commerce/ CPA II or equivalent
• KCSE Mean Grade C minimum or equivalent
• A minimum 2 years’ relevant experience in a busy accounting/credit management department
• Proficient in MS Office suite
• Formal training in customer care or equivalent demonstrated experience.
• Excellent interpersonal, organizational and customer service skills.      
• Excellent communication skills both written and verbal
• Ability to work in and build relationships among team members.
• Ability to work under pressure and meet stringent deadlines.
• Ability to work long hours with minimal supervision, has initiative and is proactive
• Accuracy & efficiency in handling demanding workload.
• Knowledgeable and can perform routine/non routine assignments