NOT Getting Job Interviews? Get A Professional CV Today. Click Here For Details

Medical Care Assessor Job, Current Medical Jobs Kenya,

REPORTS TO: CREDIT MANAGER

JOB SUMMARY

The Medical care assessor ensures smooth operations in all aspects of the hospital operation.

The job entails;

  • Billing guide management
  • Cost containment
  • Medical claims management
  • Follow-up and escalation of urgent issues
  • Co-ordination and daily reporting on matters
  • Reconciliation and resolution of queries among others

CORE RESPONSIBILITIES

Billing guide management

  • Create and implement a billing guide with checkpoints that can guide revenue officers on any under billings or over billings
  • Check all bills (Inpatient and Outpatient) raised in the hospital for any mistakes during billing.
  • Create relevant checklists for all wards for use by the billing team when charging patients.
  • Ensure all medical insurance billing policies and procedures are adhered to
  • Act as the interface between patients, doctors, and other departments regarding professional billing operations
  • Keep safe custody of all passwords issued for use in the various hospital systems.

Cost containment

  • Work with various teams to create appropriate hospital packages (Inpatient and Outpatient)
  • Continuous review of the hospital packages ensuring they remain competitive in the market by benchmarking against similar systems
  • Review capitation bills/fixed cost bills and ensure any bills that cross the stated amounts are justified
  • Report daily any incidences involving bills with issues/those that have crossed the insurance limits.
  • Liaise with the doctor to ensure that the appropriate length of stay is achieved.
  • Cross check the branded vs generic mix and ensure that it is in line with hospital policies and the healthcare industry.
  • Share a daily report on the capitation/ fixed cost bills.
  • Ensure all items used on a patient are billed to prevent losses to the hospital
  • Ensure real time consumption of stocks received by various departments

Medical Claims management

  • Supervise and ensure all the required claim documents have been filled by patients and doctors for forwarding to insurance.
  • Correct any mismatch between diagnosis and treatment on claim forms before the bill is dispatched to the insurance.
  • Respond to insurance clinical queries arising from time to time.
  • Supervise and ensure all the required claim documents have been filled by patients and doctors for forwarding to insurance
  • Cross check all invoices to ensure completion and handover to the dispatch team daily.

Human Capital

  • Ensure periodic departmental trainings are done and reports shared with Human Resource.
  • Supervise and ensure excellent customer experience is delivered and maintained
  • Ensure real time communication to Revenue Officers regarding matters billing from Management

MINIMUM REQUIREMENTS/ QUALIFICATIONS

  • Diploma in Community Health Nursing
  • 1 Year working in a busy Health facility

KEY JOB REQUIREMENTS

  • Strong written and oral communication skills
  • Strong computer skills
  • Ability to work in a fast-paced and high demand environment
  • Flexibility of working with many different types of people and situations
  • Strong and highly visible team player with relationship building skills

How To Apply

Qualified and interested candidates should send their application letter and curriculum vitae to careers@premierhospital.org clearly indicating on the email subject the position being applied for. The application should be received not later than 5.00pm on Wednesday 20th October 2021. Only short-listed candidates will be contacted.

N.B: Looking For A New Job? Find Your Next Job With Us. Click Here To Register Your CV. It's Free.