Key Responsibilities and Duties

• Ensure timely reconciliation, payments and sign off of healthcare service provider accounts.
• Maintaining strong working relationships with service providers, Clients, all departments and all business stakeholders.
• Ensure prompt Authorization and processing of all healthcare payments up to the approved limits.
• Ensure accuracy of General Ledger balances through reconciliations.
• Complying with statutory, regulatory and internal control processes including internal & external audits recommendations.
• Entrenching performance-based appraisal of departmental staff in line with their set KPI’s and departmental targets.
• Monitor, prevent and control fraud by carrying out regular audits on the internal and external systems and processes.
• Supervise, train and mentor reconciliation and payments staff to achieve a high level of motivation and productivity.
• Ensure self-funded schemes are sufficiently funded and accounted for and generation of utilization reports.
• Management of cashflows to ensure timely payment of all suppliers; and timely investment of surpluses.
• Prepare regular reports to management and providers and advice the business on relevant controls required.
• Foster good relationship with service providers and agree on credit terms.
• Respond to customer queries both internal and external to meet the objectives of the customer charter.
• Perform any other duties assigned from time to time.

Skills and Competencies Required

• Strong leadership and management skills.
• Ability to work independently and build effective interpersonal relations.
• Bias towards innovation and development of new ideas in problem solving.
• Professionalism in dealing with both internal and external stakeholders.
• Excellent communication and negotiation skills.
• Extensive networking with service providers and other medical insurers.
• Excellent analytical and monitoring skills.
• Ability to evaluate decisions made in benefit utilization management.
• Integrity and honesty.

Knowledge & Experience

• At least 4 years relevant work experience.
• Technical accounting knowledge.
• Understanding of insurance accounting and management.
• Knowledge regulatory framework and requirements.
• Good communication and reporting skills.
• Good negotiation and interpersonal relationship skills.

Academic and Professional Qualifications required

• Graduate degree in business administration or related field.
•  CPA(K)