Entitlement Officer 41 views

Introduction

Aga Khan University Hospital, Nairobi is a private not-for-profit teaching hospital that provides tertiary and secondary level healthcare services.  It is one of the hospitals in East Africa accredited by the Joint Commission International from USA.  The University Hospital has been providing high quality care for the people of East Africa and beyond for over 60 years.
Applications are invited from appropriately qualified candidates with a clinical background for the position of Entitlement Officer in the Debtors Section, Finance Division.

Responsibilities

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.

  • 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.

Requirements

  • 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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