Summary: Claims Officer at Ciala Hospital: Processes medical insurance claims, reconciles billing discrepancies, handles pre-authorizations, and liaises with insurance providers. Requires a degree or diploma in Health Records, Business, or Nursing, knowledge of medical coding, and 2+ years of hospital claims management experience. Full-time.
We are looking for professionals who demonstrate professionalism, integrity, teamwork, accountability, good communication and commitment to quality patient care.
The
Claims Officer will oversee patient registration, billing, cashiering, claims
processing and claims follow-up, while supporting effective revenue collection
and preventing revenue leakage.
Key Responsibilities
- Register patients and verify patient, payer and insurance/SHA
details.
- Confirm eligibility, authorisations and required documentation.
- Prepare and process patient bills and receive approved payments.
- Reconcile daily collections and identify billing discrepancies.
- Ensure all services provided are accurately captured and billed.
- Prepare and submit accurate SHA and private insurance claims.
- Track submitted, pending, queried, rejected and paid claims.
- Follow up outstanding and rejected claims and coordinate corrections
and resubmissions.
- Identify billing errors, missing documentation, underbilling and
other revenue leakage.
- Coordinate with clinical, nursing, pharmacy, laboratory, theatre,
radiology, records and finance teams to resolve claims and billing issues.
- Maintain accurate claims and revenue records and prepare regular
reports for management.
Requirements
- Diploma or degree in Health Records, Health Administration,
Insurance, Finance, Accounting, Medical Claims Management or a related
field.
- Hospital experience is strongly preferred.
- Experience with SHA and private medical insurance claims is an added
advantage.
- Good computer, billing, reconciliation and documentation skills.
- Strong communication, follow-up and problem-solving abilities.
- High level of integrity, confidentiality, discipline and
accountability.
How to Apply
Interested and qualified
candidates should forward their CV to: careers@cialahospital.com using the position as
subject of email.
