Job Purpose
The main purpose of the job is to provide correct billing for patients under cash, private insurances and SHA/SHIF cover in an accurate and timely manner.
Key duties and responsibilities
Prepare billing statements for insurance companies, cash and corporate patients and other third parties
Review the discharge sheets for accuracy and completion to prepare billing statements
Analyze invoices and data, prepare reports and respond to inquiries concerning billing activities
Ensure pre-authorizations are done for corporate and SHA/SHIF clients
Verify SHA/SHIF status and approvals and ensure biometrics capture as per procedure
Update patients’ bills daily in coordination with other billing points within the hospital and other external partners
Ensure that all services offered are billed/invoiced
Update the corporate and cash payers on their bills daily or on-demand
Carry out daily routine ward rounds to collect billing information and update the clients and patients
Check insurance/corporate/ SHA/SHIF documents for authenticity and validity
Establish payment arrangements with patients; monitor payments; following up with patients when payment lapses occur
Discharge clients by processing their bills and issuing gate passes
Prepare daily, weekly and monthly billing reports
Post/process bills in the correct and relevant accounts in the system
Prepare the physical corporate / SHA/SHIF invoices-claims and attach the relevant documents for dispatch within the agreed credit period
Participate in stock take exercises
Ensure safe custody of all documents/LOUs /Guarantee of Payments used in discharging Corporate clients
Serve and protect the hospital’s image by adhering to professional standards, hospital policies and procedures
Any other responsibility assigned to the jobholder by the supervisor from time to time
Follow up with insurance companies, SHA/SHIF and other corporate players for timely payment of claims
ETIMS: entering all corporate invoices in ETIMS, generating all receipts and filling them according to receipt number
Any other relevant roles as may be assigned by the administration
Qualifications
Degree or Diploma in Business Administration, Economics, Finance or other business-related fields from a recognized institution.
Partial accounting qualification, i.e. CPA Part II or ACCA 2.
Minimum of 4 years’ experience, with two years in a billing function in a busy health facility
Must have experience in processing SHA/SHIF and insurance claims
Competencies
Computer literacy,
Accounting skills
Attention to detail
Customer relation skills
Communication skills
Negotiating skills
Educational Qualifications
Diploma or Bachelor’s Degree in:
Accounting
Finance
Business Administration
Health Records and Information Management
Any other related field
Professional Certifications (Optional but Preferred)
CPA (Certified Public Accountant) – at least CPA Part I or II
ACCA (Association of Chartered Certified Accountants)
CHRP (Certified Healthcare Revenue Professional)
Experience Requirements
At least 4 years of experience in hospital billing, medical claims processing, or healthcare finance.
Experience with SHIF and private insurance claims.
Knowledge of hospital billing software and accounting systems.
Key Skills Required
Strong knowledge of hospital billing procedures and insurance claims processing.
Familiarity with SHIF and private insurance policies.
Proficiency in Microsoft Office and hospital billing software.
Excellent analytical and numerical skills.
Strong communication and customer service skills.
Ability to work under pressure and meet deadlines
You are required to attach a Cover letter, CV and copies of certificates.These documents should be merged into one PDF document;Addressed to: The Human Resources ManagerNairobi Adventist HospitalP.O. Box 41352-00100NairobiQuoting the position applied for as the subject line;Application deadline: Before 5 pm on 11th April 2025
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