Healthcare and MedicalFull-TimeJunior-level(1-2 yrs)
Job Description
Radiant Group of Hospitals (RGH) is a leading healthcare provider in Kenya and beyond, known for providing quality and affordable healthcare. We are looking for a competent and qualified Medical Claims Officer to join our team in Nairobi.
Role Overview
The Medical Claims Officer is responsible for the end-to-end management of medical claims within the hospital. This includes ensuring accurate coding, verifying insurance eligibility, and liaising with regulatory bodies and insurance providers to ensure timely and accurate reimbursements.
Responsibilities and Duties
Manage the claims process within a high-volume hospital environment.
Ensure accurate medical coding of patient diagnoses and procedures.
Review and validate medical records to support claims submissions.
Monitor the status of submitted claims and handle any rejections or discrepancies.
Ensure compliance with the Social Health Authority (SHA) and other insurance regulatory requirements.
Maintain effective communication with insurance partners to facilitate smooth processing.
Requirements and Qualifications
Must hold a Diploma or Degree in Nursing or Clinical Medicine.
A minimum of 2 years of professional experience in claims management within a busy hospital setup.
High level of proficiency in medical coding.
Strong analytical skills and attention to detail.
Comprehensive understanding of Kenyan insurance regulations and the Social Health Authority (SHA) framework.
How to Apply
Interested and qualified candidates are invited to submit their applications via email to careers@radianthospitals.org. The deadline for all applications is March 30th, 2026.
How to Apply
Interested candidates should submit their application via email to careers@radianthospitals.org no later than March 30th, 2026.
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