Key Responsibilities
Billings
i. Prepare daily bills and statement estimates for all patients and corporate customers, including HMOs and retainership accounts.
ii. Upload bills and claims on HMO and retainer portals in line with agreed timelines and requirements.
iii. Issue invoices by accurately entering service data, applying approved discounts, and dispatching invoices to customers.
iv. Ensure the accuracy of patient bills (both outpatient and inpatient) based on approved cash tariffs and agreed rates with HMOs and corporate customers.
v. Escalate claim forms with improper patient data capture or prescription issues to Clinical Audit and Internal Control to prevent potential revenue loss.
vi. Participate in periodic reviews of HMO and corporate customer tariffs to prevent underbilling or overbilling.
vii. Ensure all bills are accurately processed and posted on the Accounting ERP system.
viii. Respond to billing and reconciliation queries raised by all categories of customers within the agreed turnaround time.
ix. Collaborate with internal stakeholders to ensure effective revenue assurance across the division.
x. Perform any other duties as assigned by the Group Head, Billings & Transaction Settlements (BTS).
xi. Act as a backup to the Group Head, Billings & Transaction Settlements (BTS) when required.
Reconciliation
i. Perform timely reconciliation of all bank statements to ensure completeness and accuracy of financial records.
ii. Reconcile inflows received against bills issued to HMOs and follow up on identified gaps with the respective HMOs.
iii. Reconcile payments received from customers within the Care Division to ensure accuracy and completeness.
Audit
i. Support and ensure the completion of the annual audit exercise within the agreed timeframe, achieving zero audit exceptions.
Profile
1. Minimum of 5 years’ experience in Retail Transaction and Settlement services within the healthcare, retail, or banking industry.
2. Strong understanding of retail and hospital billing and settlement processes.
3. Excellent numerical and reconciliation skills with a high level of attention to detail.
4. Strong relationship management and stakeholder engagement skills.
5. Demonstrated leadership capability with the ability to guide teams effectively.
6. Proven ability to innovate and lead the development of new, value-adding platforms and processes.
7. Strong organizational skills with exceptional attention to detail.
8. Excellent computer proficiency, including Microsoft Office Suite and accounting applications.
9. Strong verbal and written communication skills.
10. Bachelor’s or Master’s degree in a business-oriented discipline; professional qualifications in numerate disciplines are an added advantage.
To apply for this job email your details to careers@afya.care