Penda Health – Claims Officer.

This position is responsible for effective management of invoices and claims from the medical centers and delivery to the credit clients within the set timelines.

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  • Nairobi, Kenya
  • Full Time
  • Support Office
  • Entry Level

About Penda

Penda Health is an award-winning private company that is transforming healthcare in Kenya by making extremely high-quality care accessible to every family and by offering unparalleled patient experiences. Our vision is that everyone in Africa has healthcare they can trust. We were ranked as the best healthcare company to work for in Kenya in 2018!

We currently have ~300 staff operating 14 branches and treating ~200K+ patients per year across Nairobi. By the end of 2020, we will be operating 40 branches in multiple countries with a staff of over 1,000 and treating ~800K+ patients per year.

Job Description

This position is responsible for effective management of invoices and claims from the medical centers and delivery to the credit clients within the set timelines.
The role further supports the medical centers in reducing the rejected claims and errors on insurance claims. The role holder will support the Credit Manager in ensuring that money owed to Penda is received within the expected timelines by ensuring timely reconciliations, allocation of payments and dispatch of statements to the Insurance and companies that owe Penda money and those in capitated agreements.

Job purpose
This role is responsible for timely collection of debts and in liaison with the Medical centers and branch management, ensure effective management of the credit business.

Duties and responsibilities

  • Major responsibility: Making Penda a Great place to work for all! By ensuring Smooth billing and invoicing of all credit sales and the Medical Centers are always updated and have the resources and information they need to bill credit patients.
  • Be a great teammate: Take feedback well, be open and honest about problems you are facing, take on conflict with your colleagues in a healthy way, and work hard to improve the network & systems for your colleagues!
  • Re-stocking of insurance Claim forms and ensuring there are enough forms at the Medical Centers.
  • Effective and timely collection and processing of insurance claims and invoices from the Medical Centers to the support office.
  • Verification of claim forms and invoices against records.
  • Timely delivery of verified invoices to the insurance for settlement.
  • Prepare and generate client statements and respond through the Credit Manager to issues regarding the statements as raised by the clients.
  • Weekly reconciliation, production, and circulation of a report for all claims against the invoice summary records.
  • Promptly updating Medical Centers on any changes in the valid insurance lists as received from insurance partners.
  • Periodic Training of Staff on Claims processing procedures to minimize on Rejected claims. 
  • Tracking rejected claims and errors on claims/invoices and follow up for timely resolution and updating the rejected claims register.
  • In Liaison with the Credit Manager ensures proper records for all accounts on credit.
  • Any other duties that may be assigned fro time to time

Requirements

  • At least one-year work experience in a fast-paced environment with strict turnaround times.
  • Experience handling medical claims will be an added advantage.
  • You are creative, and you can think on your feet and respond to operational problems with
    speed.
  • You are flexible to learn and adjust to changes in medical claim routines and
    operational standards
  • A person with high integrity.
  • Advanced Excel and strong analytical skills.
  • Great team player, able to contribute to the team efforts

Package

  • Working for a company that has a real chance to revolutionize the healthcare industry
  • Competitive salary (including employee stock options)
  • Medical cover for inpatient and outpatient for your whole family
  • Support to invest in your own growth (onsite mini-library of business books, budget for conference and training attendance)
  • Great benefits package – including “mandatory” hiking days and fruit salads at the office!

How to apply?

Candidates will be evaluated on a rolling basis (first to apply is first to be evaluated).

Penda Health is an equal opportunity employer and does not discriminate in employment based on race,
color, sex, religion, national origin, age, sexual orientation, marital status or disability.

Apply Here


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