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 and 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
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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