Role Summary

The role holder will ensure timely collection of outstanding payments with the aim of keeping debt levels at a minimum and effectively conclude reconciliations contributing to the overall financial sustainability of the hospital’s operations. He/she will assist in ensuring payer-provider service level agreement guidelines and communications are disseminated in a timely manner and enforced.

Key Duties and Responsibilities

• Follow up for timely payment of all due amounts as per the SLA to preserve the cash flow position.
• Establish debtor follow-up and recovery mechanisms to reduce bad debts.
• Undertake monthly account reconciliation and send out statements as per the hospital’s credit control policy and timelines.
• Ensure timely dispatch of processed claim documents to insurance companies.
• Confirm and communicate all dispatches and statements to insurance companies every month.
• Handle disputes regarding bills and follow up to bring payment within the agreed terms.
• Follow up on remittances and ensure timely allocation of payments received.
• Undertake timely periodic reconciliation and sign-offs of debtor accounts.
• Client relationship management, including responding to queries on credit business professionally and efficiently and coordinating with various teams to meet client needs with the hospital.
• Ensure timely updates of schemes and plans on the HMIS and to service teams.
• Continuous sensitization of the client services, clinical and claims processing teams on insurance feedback and requirements.
• Identify changes in payment patterns and propose action to avert indebtedness.
• Prepare and timely submit dynamic progress reports, e.g. disputed claims, rejections, collection efficiency, etc., to the Supervisor.
• Perform any other duties as may be assigned by the Supervisor from time to time.

Competencies Required

• Excellent customer service skills.
• Effective communication skills – listening, oral and written.
• Excellent negotiation skills.
• Highly ethical, has integrity and observes confidentiality.
• Strong work ethic with attention to detail.
• Sound analytical, problem-solving, and decision-making skills.
• Ability to work under pressure and meet timelines with minimum supervision.
• Highly organized with good time management skills.
• Good interpersonal skills and a team player.

Qualifications and Experience

• Bachelor of Commerce in Finance, Accounting or related degree from a recognized institution.
• Professional qualifications such as Certified Public Accountant (CPA) K / ACCA.
• At least five (5) years of working experience, with at least three (3) years in a busy credit control hospital setting.
• Knowledge of medical terminology and medical bills documentation evaluation.
• Good working knowledge of Accounting Softwares, MS Office Suite (Excel, Word, PowerPoint, and Outlook) and the Internet.