Job Description

Job Purpose:

The role holder will be responsible for Medical Accounting including; Fund management, premium collections, provider reconciliations and ensuring that provider payment are made on time
Key responsibilities
Payments and Reconciliation

• Prepare monthly hospital payout targets for major providers and send the list to the Medical Claims Team


•  Generate and send remittance advice for payments made to the respective medical providers including the invoice details. 


•  Review payouts on a regular basis with an aim of ensuring that monthly payout targets for major providers are met.


• Perform reconciliations with provider statements and ensure resolution of outstanding balances on a timely basis.


• Reconcile Britam Credit account facilities with the various providers and ensure the same is maintained within the agreed SLAs.


• Monitor medical provider guarantees to ensure timely renewal of expired guarantees and cancellations for discontinued providers.

Fund & Insured Schemes Management

• Monitor utilization of funded schemes and follow up on replenishment at 75% utilization


• Generate and issue monthly fund utilization statements and Insured schemes on request


• Advise cashier on the receipting and allocation for all medical collections including; Insured premiums, Funded schemes, and card costs


• Perform monthly reconciliation of funded schemes and agree to balances to ERP General Ledger Out Patient fund account. 


• Generate Insured premium statement and facilitate collection of the same with the Sales team and intermediaries


• Reconciliation and collection/recovery of medical claims paid outside the policy. 


• Process medical premium refunds to clients

Knowledge, experience, and qualifications required

• Bachelor's degree in a business-related field


• CPA(K) or other similarly recognized accounting profession qualification


• 2-3 years of accounting experience in a similar role


• Knowledge of ERP AP system and/or experience of using Oracle Financials would be an advantage


• Strong  computer and business solutions software skills


• Strong analytical and problem-solving skills


• Analytical skills

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