Medical Debt Collector

JOB DESCRIPTION FOR MEDICAL DEBT COLLECTOR

JOB TITLE: Medical Debt Collector

REPORTS TO: CLINICAL COORDINATOR

INTERFACES WITH: CLAIMS DEPARTMENT, MEDICAL DIRECTOR, FINANCE MANAGER

JOB PURPOSE

To monitor, track, document, review and recover all organizational debts

KEY RESPONSIBILITIES

• Primarily responsible for monitoring, tracking, documentation and review of ALL insurance disputes from all insurance companies
• Ensuring that disputes are kept reducing as per set targets
• Training and re-orientation of all staff at the different service points about exclusions and causes of disputes.
• Engaging the medical and insurance teams constantly giving feedback related to disputes
• Liaise with the clinical coordinator to update the exclusion list.
• Following up with Insurance companies for payment break down for each payment to capture unpaid amounts
• Responsible for preparing supporting documents for bills to be resubmitted
• Following of unpaid rejected and disputed amounts for payment with the different insurance companies
• Be in charge of payment reconciliations with all insurance companies
• Maintain a good healthy relationships with our insurance partners.
• Prepare monthly reports
• Monitor, track and follow up for payments by individual debtors and Family Health
• Allocation of payments in the HMI system

OUTPUTS

• Monthly Reconciliation reports with Insurance companies and minutes of reconciliation meetings
• Monthly disputes Breakdown report and Dispute analysis reports
• Monthly re-submission of disputed bills and update on payment (reports)
• Reduction of Disputes amounts by percentage: 25% by the end of 6 months. 50% by end of the year.
• Monthly Report summary of causes of disputes from different insurance companies
• Relationship Management of Insurance Companies.
• Monthly engagement of all stakeholders on disputes arising.
• Monthly Report of Individual and Family Health Debtors’ position

EDUCATION, EXPERIENCE AND COMPETENCIES

• Bachelor’s Degree in Nursing
• Certificate and proficiency in computer applications
• At least 2 years’ experience and competence in a clinical setting
• Knowledgeable of medical insurance
• Experience in relationship management will be added advantage
• Basic calculus skills
• Self-driven, result oriented and able to follow up
• Assertive and confident
• Clinical competence
• Good interpersonal and communication skills

HOW TO APPLY.

NB: Only shortlisted candidates will be contacted. Any form of canvassing will leadf to automatic disqualification.