Job Purpose:
The role holder will be responsible for Medical Accounting including; Fund management, premium collections, provider reconciliations and ensuring that provider payment are made on time
Key responsibilities
Payments and Reconciliation
Prepare monthly hospital payout targets for major providers and send the list to the Medical Claims Team
Generate and send remittance advice for payments made to the respective medical providers including the invoice details.
Review payouts on a regular basis with an aim of ensuring that monthly payout targets for major providers are met.
Perform reconciliations with provider statements and ensure resolution of outstanding balances on a timely basis.
Reconcile Britam Credit account facilities with the various providers and ensure the same is maintained within the agreed SLAs.
Monitor medical provider guarantees to ensure timely renewal of expired guarantees and cancellations for discontinued providers.
Fund & Insured Schemes Management
Monitor utilization of funded schemes and follow up on replenishment at 75% utilization
Generate and issue monthly fund utilization statements and Insured schemes on request
Advise cashier on the receipting and allocation for all medical collections including; Insured premiums, Funded schemes, and card costs
Perform monthly reconciliation of funded schemes and agree to balances to ERP General Ledger Out Patient fund account.
Generate Insured premium statement and facilitate collection of the same with the Sales team and intermediaries
Reconciliation and collection/recovery of medical claims paid outside the policy.
Process medical premium refunds to clients
Knowledge, experience, and qualifications required
Bachelor’s degree in a business-related field
CPA(K) or other similarly recognized accounting profession qualification
2-3 years of accounting experience in a similar role
Knowledge of ERP AP system and/or experience of using Oracle Financials would be an advantage
Strong computer and business solutions software skills
Strong analytical and problem-solving skills
Analytical skills
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