Billing Officer Job (50-60K)
Finance Jobs.
Duties and Responsibilities
Patient Billing & Invoicing
- Generate accurate invoices for all patient services including consultation, lab tests, imaging, surgery, medication, and ward charges.
- Confirm patient insurance status and coverage before billing.
- Work closely with reception, nursing, pharmacy, and clinical departments to ensure all billable services are captured correctly in the hospital management system.
Claims Management (NHIF/SHA/Private Insurers)
- Prepare and submit claims to NHIF, SHA, and insurance companies in the prescribed formats and timelines.
- Verify patient eligibility and benefits before submission of claims.
- Attach all necessary documentation, including patient records, prescription notes, treatment summaries, and consent forms, to claims.
Reconciliation and Follow-up
- Track submitted claims and ensure timely payment.
- Investigate and resolve unpaid, denied, or rejected claims by liaising with insurers, NHIF/SHA, and internal departments.
- Reconcile remittances received from NHIF/SHA/insurance against submitted claims to identify variances.
Patient and Insurer Liaison
- Respond to patient inquiries regarding billing, insurance coverage, and outstanding balances.
- Communicate with insurance providers and NHIF/SHA offices to resolve claim discrepancies.
- Provide preauthorization support where required for procedures or admissions.
Reporting and Documentation
- Prepare daily, weekly, and monthly billing and collection reports for hospital management.
- Maintain comprehensive and organized billing records in accordance with hospital and regulatory requirements.
- Assist in audits by providing billing records and explanations as needed.
Compliance and Quality Assurance
- Ensure billing practices comply with hospital policies, NHIF/SHA regulations, and insurance agreements.
- Regularly update knowledge on NHIF/SHA changes and ensure hospital billing aligns with the latest policies.
- Identify and report any fraudulent or irregular billing activity.
Key Requirement Skills And Qualification
- Diploma or Bachelor’s Degree in Accounting, Finance, Business Administration, Health Records and Information, or a related field
- Minimum 2–3 years of working experience in hospital billing or in a health insurance company, specifically handling NHIF and insurance claims
- Proficient in using hospital management systems (e.g. Smart HIMS, AfyaPro, Med360, etc.)
- Deep understanding of Kenya’s health insurance landscape, including NHIF, SHA, and private insurers
- Knowledge of medical terminology, procedures, and diagnosis codes (ICD-10) is a strong advantage
HOW TO APPLY
If you meet the above qualifications, skills and experience share CV on jobs@britesmanagement.com
Interviews will be carried out on a rolling basis until the position is filled.
Only the shortlisted candidates will be contacted.
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