Job purpose\:    
The role holder will be responsible for Medical Accounting including Fund management, general ledger reconciliations, premium collections, provider reconciliations and ensuring that provider payments are made on time.

Key responsibilities\:

Payments and Reconciliation\:

Prepare monthly hospital pay out targets for major providers and send the list to Medical Claims Team. 
Generate and send remittance advises for payments made to the respective medical providers including with the invoice details. 
Review pay outs on a regular basis with an aim of ensuring that monthly pay out targets for major providers are met.
Perform reconciliations with provider statements, ensure resolution of outstanding balances on a timely basis and obtain clearance letters from providers.
Reconcile Britam Credit account facilities with the various providers and ensure the same are maintained within the agreed SLAs.
Monitor medical provider guarantees ensuring timely renewal of expired guarantees and cancellations for discontinued providers.
Negotiate for provider efficiency discounts & annual volume discounts.
Facilitate recoveries on payments above average.
Delegated Authority\:  As per the approved Delegated Authority Matrix.

Fund & Insured Schemes Management\:

Monitor utilization of funded schemes and follow up on replenishment at 75% utilization.
Generate and issue monthly fund utilization statements and Insured schemes on request.
Advise cashier on the receipting and allocation for all medical collections including; Insured premiums, Funded schemes and card costs.
Perform monthly reconciliation of funded schemes and agree balances to ERP 

General Ledger Out Patient fund account\: 

Generate Insured premium statement and facilitate collection of the same with the Sales team and intermediaries.
Reconciliation and collection/recovery of medical claims paid outside policy. 
Process medical premium refunds to clients.
Prepare monthly reports on provider reconciliation status on reconciliation, discounts, sign off & clearance. Ensure all service providers are etims complaint.

General Ledger Reconciliations\:

Prepare monthly reconciliation of general ledgers assigned and pass any adjusting entries to ensure accuracy of amounts reported.

Job purpose\:    
The role holder will be responsible for Medical Accounting including Fund management, general ledger reconciliations, premium collections, provider reconciliations and ensuring that provider payments are made on time.

Key responsibilities\:

Payments and Reconciliation\:

Prepare monthly hospital pay out targets for major providers and send the list to Medical Claims Team. 
Generate and send remittance advises for payments made to the respective medical providers including with the invoice details. 
Review pay outs on a regular basis with an aim of ensuring that monthly pay out targets for major providers are met.
Perform reconciliations with provider statements, ensure resolution of outstanding balances on a timely basis and obtain clearance letters from providers.
Reconcile Britam Credit account facilities with the various providers and ensure the same are maintained within the agreed SLAs.
Monitor medical provider guarantees ensuring timely renewal of expired guarantees and cancellations for discontinued providers.
Negotiate for provider efficiency discounts & annual volume discounts.
Facilitate recoveries on payments above average.
Delegated Authority\:  As per the approved Delegated Authority Matrix.

Fund & Insured Schemes Management\:

Monitor utilization of funded schemes and follow up on replenishment at 75% utilization.
Generate and issue monthly fund utilization statements and Insured schemes on request.
Advise cashier on the receipting and allocation for all medical collections including; Insured premiums, Funded schemes and card costs.
Perform monthly reconciliation of funded schemes and agree balances to ERP 

General Ledger Out Patient fund account\: 

Generate Insured premium statement and facilitate collection of the same with the Sales team and intermediaries.
Reconciliation and collection/recovery of medical claims paid outside policy. 
Process medical premium refunds to clients.
Prepare monthly reports on provider reconciliation status on reconciliation, discounts, sign off & clearance. Ensure all service providers are etims complaint.

General Ledger Reconciliations\:

Prepare monthly reconciliation of general ledgers assigned and pass any adjusting entries to ensure accuracy of amounts reported.

Knowledge, experience and qualifications required\:

Bachelor's degree in a business related field.
CPA(K) or other similarly recognized accounting profession qualification.
2-3 years of accounting experience in a similar role.
Knowledge of ERP AP system and/or experience of using Oracle Financials would be an advantage.
Strong  computer and business solutions software skills.
Strong analytical and problem solving skills.
Analytical skills.

Technical/ Functional competencies\:

Knowledge of insurance regulatory requirements.
Knowledge of insurance products.
Sales and marketing management skills.

Knowledge, experience and qualifications required\:

Bachelor's degree in a business related field.
CPA(K) or other similarly recognized accounting profession qualification.
2-3 years of accounting experience in a similar role.
Knowledge of ERP AP system and/or experience of using Oracle Financials would be an advantage.
Strong  computer and business solutions software skills.
Strong analytical and problem solving skills.
Analytical skills.

Technical/ Functional competencies\:

Knowledge of insurance regulatory requirements.
Knowledge of insurance products.
Sales and marketing management skills.