Medical Claims Officer Job Opportunities – Kampala Hospital

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Job Detail

  • Job ID 25804

Job Description

Job Title:  Medical Claims Officer

Organisation: Kampala Hospital

Duty Station: Kampala, Uganda

Reports to: Finance Manager

 

About US:

Kampala Hospital is a privately-owned hospital that was established in 2007. Our mandate was and is to bring non-existent services to the countries that were often sought by many people who frequently moved abroad to seek quality medical care.

 

Job Summary: The Medical Claims Officer will ensure the completeness and accuracy of all the Insurance Billings on a daily basis, follow up, and submissions of all insurance Claims and rejections.

 

Key Duties and Responsibilities:

  • Ensure all claims are vetted and audit claims received on a monthly basis.
  • Oversee claims daily operations to ensure accuracy and completeness of each patient File.
  • Ensure that all medical diagnostic related rejections are minimized to a zero percent and a monthly rejection report is submitted to the finance manager.
  • Frequently give back to the affiliate doctors/specialist and all other stake holders on Insurance exclusions and limits.
  • To be responsible for reconciling disputed claims with the respective doctors.
  • To internally source for medical explanations from the respective personalities/officers to be able to explain any claims rejections and assist the credit controller in resubmitting them to the Insurance Companies for payment.
  • To regularly Liaise with the Insurance Companies and be able to meet and explain any variances in the Claims.
  • To perform any other duties that may arise in line with this role or the function it supports and as assigned from time to time.

 

Key Deliverables

  • Assess claim forms daily to ensure proper billing and completeness
  • Ensure submission of claims by 5th of every month
  • Eliminate rejection of claims to 0%
  • Evaluates claims with regards to eligibility
  • Coordinates workflow and meet all deadlines




Qualifications, Skills and Experience:

  • The ideal candidate should hold a Diploma in Clinical Medicine or bachelor’s in medicine being an added advantage.
  • At least three to five years of experience as a Claims Officer
  • Willingness to work a flexible schedule and fill in when required
  • Excellent communication skills
  • Proficient computer skills
  • Good working knowledge of healthcare Insurance
  • Accurate and precise attention to detail
  • Ability to work well with management and staff at all levels

 

How to Apply:

All candidates should Email their applications with updated CVs to: [email protected]

 

Deadline: 15th June 2022

 

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