Avenue Hospital was founded in 1995 for the purpose of managing the outpatient department at the Hospital, and to extend medical services to corporate clientele through an innovative concept of Managed Healthcare.
Job Objective/Purpose
To ensure that all services rendered are billed appropriately per patient episode and that all requisite documentation is collated with invoices and claims forms before being processed for onward transmission to insurance companies.
Main Responsibilities
- To ensure that all services rendered are billed appropriately per patient per episode.
- Ensure all smart cards are run and invoices are signed by clients.
- Ensure bills are as per the set limits by the insurance and if they surpass, seek approval.
- Seek pre-authorizations from various insurances.
- Ensure patients are billed under correct insurance schemes.
- Ensure all claims forms are collected from various departments, sick sheets and relevant invoices are attached, and they are complete (diagnosis, doctor’s and patient signature, stamped).
- Prepare and dispatch insurance and direct credit invoices to the accounts receivable team within the stipulated deadlines.
- Ensure all OP bills are finalized in the hospital information system.
- Filling of supporting documents.
- Maintain client/patient privacy and confidentiality at all times.
- Corporate Governance:
- Carry out all activities in an ethical way.
- Report any unethical behavior.
- Quality Standards:
- Record and report all sentinel incidents/events are recorded and reported within 24 hours using the provided tools (incident reporting book in terms of customer dissatisfaction or incident reporting form where applicable).
- Client Satisfaction: Ensure client satisfaction through quality of service, communication, feedback and escalation of any unresolved issues to your respective line manager.
- Assist the receptionists in their role when called upon.
- Any other duty that as assigned to you by your supervisor in line with your job description.
Key Deliverables for this position
- Ensure accurate billing.
- Timely finalization and dispatch of invoices.
- Proper documentation and records maintenance.
Academic and Professional Qualifications
- A Diploma or Degree in Accounting, Finance, or a related field from a recognized institution.
- Professional certification such as CPA (from Part 2) or its equivalent will be an added advantage.
- At least 1-2 years of experience in an accounting role, preferably in a medical or healthcare facility.
