Claims Officer Job Ciala Hospital, Kisumu, Kenya

We are looking for professionals who demonstrate professionalism, integrity, teamwork, accountability, good communication and commitment to quality patient care.

The Claims Officer will oversee patient registration, billing, cashiering, claims processing and claims follow-up, while supporting effective revenue collection and preventing revenue leakage.

Key Responsibilities

• Register patients and verify patient, payer and insurance/SHA details.
• Confirm eligibility, authorisations and required documentation.
• Prepare and process patient bills and receive approved payments.
• Reconcile daily collections and identify billing discrepancies.
• Ensure all services provided are accurately captured and billed.
• Prepare and submit accurate SHA and private insurance claims.
• Track submitted, pending, queried, rejected and paid claims.
• Follow up outstanding and rejected claims and coordinate corrections and resubmissions.
• Identify billing errors, missing documentation, underbilling and other revenue leakage.
• Coordinate with clinical, nursing, pharmacy, laboratory, theatre, radiology, records and finance teams to resolve claims and billing issues.
• Maintain accurate claims and revenue records and prepare regular reports for management.

Requirements

• Diploma or degree in Health Records, Health Administration, Insurance, Finance, Accounting, Medical Claims Management or a related field.
• Hospital experience is strongly preferred.
• Experience with SHA and private medical insurance claims is an added advantage.
• Good computer, billing, reconciliation and documentation skills.
• Strong communication, follow-up and problem-solving abilities.
• High level of integrity, confidentiality, discipline and accountability.

How to Apply

Interested and qualified candidates should forward their CV to: careers@cialahospital.com using the position as subject of email.