Purpose

The main purpose of the job is to provide correct billing for patients under cash, private insurances and SHA/SHIF cover in an accurate and timely manner.

Key duties and responsibilities

• Prepare billing statements for insurance companies, cash and corporate patients and other third parties
• Review the discharge sheets for accuracy and completion to prepare billing statements
• Analyze invoices and data, prepare reports and respond to inquiries concerning billing activities
• Ensure pre-authorizations are done for corporate and SHA/SHIF clients
• Verify SHA/SHIF status and approvals and ensure biometrics capture as per procedure
• Update patients’ bills daily in coordination with other billing points within the hospital and other external partners
• Ensure that all services offered are billed/invoiced
• Update the corporate and cash payers on their bills daily or on-demand
• Carry out daily routine ward rounds to collect billing information and update the clients and patients
• Check insurance/corporate/ SHA/SHIF documents for authenticity and validity
• Establish payment arrangements with patients; monitor payments; following up with patients when payment lapses occur
• Discharge clients by processing their bills and issuing gate passes
• Prepare daily, weekly and monthly billing reports
• Post/process bills in the correct and relevant accounts in the system
• Prepare the physical corporate / SHA/SHIF invoices-claims and attach the relevant documents for dispatch within the agreed credit period
• Participate in stock take exercises
• Ensure safe custody of all documents/LOUs /Guarantee of Payments used in discharging Corporate clients
• Serve and protect the hospital’s image by adhering to professional standards, hospital policies and procedures
• Any other responsibility assigned to the jobholder by the supervisor from time to time
• Follow up with insurance companies, SHA/SHIF and other corporate players for timely payment of claims
• ETIMS: entering all corporate invoices in ETIMS, generating all receipts and filling them according to receipt number
• Any other relevant roles as may be assigned by the administration

Qualifications

• Degree or Diploma in Business Administration, Economics, Finance or other business-related fields from a recognized institution.
• Partial accounting qualification, i.e. CPA Part II or ACCA 2.
• Minimum of 4 years’ experience, with two years in a billing function in a busy health facility
• Must have experience in processing SHA/SHIF and insurance claims

Competencies

• Computer literacy,
• Accounting skills
• Attention to detail
• Customer relation skills
• Communication skills
• Negotiating skills

Educational Qualifications

Diploma or Bachelor’s Degree in:

• Accounting
• Finance
• Business Administration
• Health Records and Information Management
• Any other related field

Professional Certifications (Optional but Preferred)

• CPA (Certified Public Accountant) – at least CPA Part I or II
• ACCA (Association of Chartered Certified Accountants)
• CHRP (Certified Healthcare Revenue Professional)

Experience Requirements

• At least 4 years of experience in hospital billing, medical claims processing, or healthcare finance.
• Experience with SHIF and private insurance claims.
• Knowledge of hospital billing software and accounting systems.

Key Skills Required

• Strong knowledge of hospital billing procedures and insurance claims processing.
• Familiarity with SHIF and private insurance policies.
• Proficiency in Microsoft Office and hospital billing software.
• Excellent analytical and numerical skills.
• Strong communication and customer service skills.
• Ability to work under pressure and meet deadlines

These documents should be merged into one PDF document;

Addressed to: The Human Resources Manager

Nairobi Adventist Hospital

P.O. Box 41352-00100

Nairobi

Quoting the position applied for as the subject line;

Application deadline:  Before 5 pm on 11th April 2025.