Job Title: Medical Claims Officer
Organisation: Kampala Hospital
Duty Station: Kampala, Uganda
Reports to: Finance Manager
About US:
Kampala Hospital is a privately-owned hospital that was established in 2007. Our mandate was and is to bring non-existent services to the countries that were often sought by many people who frequently moved abroad to seek quality medical care.
Job Summary: The Medical Claims Officer will ensure the completeness and accuracy of all the Insurance Billings on a daily basis, follow up, and submissions of all insurance Claims and rejections.
Key Duties and Responsibilities:
- Ensure all claims are vetted and audit claims received on a monthly basis.
- Oversee claims daily operations to ensure accuracy and completeness of each patient File.
- Ensure that all medical diagnostic related rejections are minimized to a zero percent and a monthly rejection report is submitted to the finance manager.
- Frequently give back to the affiliate doctors/specialist and all other stake holders on Insurance exclusions and limits.
- To be responsible for reconciling disputed claims with the respective doctors.
- To internally source for medical explanations from the respective personalities/officers to be able to explain any claims rejections and assist the credit controller in resubmitting them to the Insurance Companies for payment.
- To regularly Liaise with the Insurance Companies and be able to meet and explain any variances in the Claims.
- To perform any other duties that may arise in line with this role or the function it supports and as assigned from time to time.
Key Deliverables
- Assess claim forms daily to ensure proper billing and completeness
- Ensure submission of claims by 5th of every month
- Eliminate rejection of claims to 0%
- Evaluates claims with regards to eligibility
- Coordinates workflow and meet all deadlines
Qualifications, Skills and Experience:
- The ideal candidate should hold a Diploma in Clinical Medicine or bachelor’s in medicine being an added advantage.
- At least three to five years of experience as a Claims Officer
- Willingness to work a flexible schedule and fill in when required
- Excellent communication skills
- Proficient computer skills
- Good working knowledge of healthcare Insurance
- Accurate and precise attention to detail
- Ability to work well with management and staff at all levels
How to Apply:
All candidates should Email their applications with updated CVs to: [email protected]
Deadline: 15th June 2022
For more of the latest jobs, please visit https://www.theugandanjobline.com or find us on our facebook page https://www.facebook.com/UgandanJobline