ROLE OVERVIEW
The successful candidate will provide strategic and operational leadership across the hospital’s billing and claims management cycle—ensuring accurate billing, timely claims submission, effective reconciliation, revenue assurance and improved claims conversion.
KEY RESPONSIBILITIES INCLUDE:
Lead hospital billing operations across outpatient, inpatient, theatre, pharmacy, laboratory, radiology and other services.
Strengthen billing accuracy and identify potential revenue leakages.
Oversee claims preparation, validation, submission and follow-up with HMOs, corporate clients and other payers.
Monitor claims ageing, rejected and queried claims, and drive corrective action.
Ensure compliance with payer requirements, contracts and healthcare financing regulations.
Reconcile services rendered, patient bills, claims submitted and approved claims.
Support payer audits and claims verification exercises.
Review rebates, write-offs and credit adjustments.
Lead, coach and develop the billing and claims team through clear KPIs, SOPs and accountability.
QUALIFICATIONS & EXPERIENCE
Bachelor’s degree in Finance, Accounting, Business Administration, Health Records, Health Management or a related field.
Relevant professional qualification is an added advantage.
At least 7 years’ relevant experience, including 3+ years in a supervisory or managerial role.
Proven experience in healthcare billing and claims management.
Strong understanding of hospital revenue-cycle management.
Experience with **EMR/HMIS, hospital information and billing systems.
Experience managing payer relationships and claims audits is highly desirable.
Strong interpersonal, communication and public relations skills.
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