Medical Administrator Job Mini Group, Nairobi, Kenya

Position Summary

Reporting to the Facility Manager / Finance Manager, the Medical Administrator will be responsible for end-to-end patient billing, insurance claims processing, SHA/NHIF and private insurer documentation, clinical administration support, cashiering controls, and daily financial reconciliation.

The role serves as a key financial and administrative control point, ensuring accurate charge capture, timely claims submission, reduced revenue leakage, audit readiness, and smooth coordination between clinical, pharmacy, laboratory, and finance departments.

Please note that Lets Heal Today is an outpatient-based healthcare provider and does not offer inpatient admission, emergency department services, or critical care management.

Key Duties & Responsibilities

Billing & Revenue Cycle Management

• Capture patient charges accurately across consultations, procedures, pharmacy, laboratory, and consumables.
• Prepare and issue invoices, receipts, and statements through computerized healthcare systems.
• Ensure complete charge capture to minimize revenue leakage across all service lines.
• Reconcile daily billing transactions against clinical services delivered and maintain accurate electronic billing records within the EHR system.

Insurance Claims Management

• Process insurance claims for the Social Health Authority, formerly NHIF, and private medical insurers.
• Verify patient eligibility, benefit coverage, and pre-authorization requirements before service delivery.
• Ensure correct coding of diagnoses, procedures, and medical services for compliant claims submission.
• Submit claims within required timelines and follow up on approvals, rejections, pending codes, and documentation gaps.

Clinical Administration & Controls

• Ensure accurate entry and complete closure of patient records within the EMR system.
• Support clinicians in maintaining complete documentation required for billing and insurance approval.
• Verify alignment between clinical notes, prescriptions, diagnostic investigations, and final billed services.

Cashiering & Financial Reconciliation

• Process patient payments securely across cash, card, and mobile money channels.
• Maintain daily cash reconciliation, banking records, and support internal financial audit readiness.

Departmental Coordination

• Coordinate with pharmacy and laboratory teams to ensure all diagnostics, dispensed items, and consumables are captured and billed correctly.
• Work with clinicians to resolve missing, unclear, or incomplete documentation affecting billing or claims processing.
• Support efficient patient flow and reduced waiting time through active administrative and queue coordination.

Compliance & Audit Support

• Ensure compliance with SHA/NHIF regulations, private insurer requirements, institutional billing policies, patient confidentiality standards, and data protection regulations.
• Participate in internal and external financial, insurance, and clinical documentation audits.

Qualifications & Experience

• Diploma or Bachelor’s Degree in Health Records, Business Administration, Finance, or a related field from a recognized institution.
• Minimum 2–3 years’ progressive hands-on experience in hospital billing, health records tracking, or medical insurance administration.
• Strong working knowledge of SHA/NHIF processes, medical coding frameworks, and private medical insurance systems within Kenya.
• Demonstrated experience working with Electronic Health Records and hospital billing or inventory modules.

Key Skills & Competencies

• Strong understanding of healthcare billing, insurance verification, and hospital revenue cycles.
• Up-to-date knowledge of SHA/NHIF rules, claims validation processes, and private insurer reimbursement structures.
• High attention to detail, numerical accuracy, and reconciliation skills.
• Strong interpersonal communication and coordination skills across clinical, pharmacy, laboratory, and finance teams.
• Ability to multitask and work under pressure in a fast-paced, high-volume outpatient clinic environment.
• High professional ethics, financial accountability, confidentiality, and commitment to data protection.

How to Apply

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