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    Medical Billing Associate - Nairobi, Kenya - Penda Health

    Penda Health
    Penda Health Nairobi, Kenya

    1 week ago

    Default job background
    Full time
    Description

    ABOUT THE COMPANY

    Penda Health is an award winning company that is transforming healthcare in Kenya by building a chain of outpatient health clinics that offer evidence-based medical care and unparalleled patient experience at surprisingly affordable rates.

    JOB SUMMARY

    Key requirements and attributes Be a Clinical Officer at Penda.1 year working experience at Penda. A great champion of Penda Way demonstrating strong leadership skills.A track record of great performance across all areas from the PR.

    RESPONSIBILITIES

    Thoroughly review claims for errors, accuracy, and completeness, rectifying any issues before submission to insurance companies. Provide direct feedback to medical centers/providers on identified errors.Coordinate pre-authorization and eligibility verification processes, ensuring compliance with insurance guidelines. Train medical center staff on insurance guidelines and provide consultation for compliance.Ensure timely dissemination of changes and communications from insurance partners to all medical centers. Maintain accurate record-keeping of invoices and communicate limits/exclusions to service points based on insurance guidelines.Support medical centers by identifying capacity gaps and providing training in medical billing. Liaise with the credit team to review disputed claims and provide clinical justification for appeals to insurance.Professionally respond to queries from insurance partners or medical centers regarding billing. Timely circulate memos to clinicians and clinical coordinators on new insurance guidelines.Scrutinize rejected claims related to clinical issues, providing guidance and coaching to medical centers to minimize claim denials. Submit invoices through designated portals for processing.

    REQUIRED SKILLS

    Accounting, Compliance, Financial controlling, Accounting IT-systems (use of)

    REQUIRED EDUCATION

    Bachelor's degree

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