Job Title: Insurance Liaison Officer
Organization: Mengo Hospital
Duty Station: Kampala, Uganda
Reports to: Accountant – Operations
About US:
Mengo Hospital was founded in 1897 in Kampala, and is the oldest
hospital in Uganda. It currently serves as an urban community hospital that
provides modern medical care. Mengo Hospital provides comprehensive care
including radiology, obstetrics, dentistry, orthopedics, and surgery.
Additionally, Mengo Hospital provides critical training and education to health
professionals through its various programs in midwifery and nursing, health
sciences, and laboratory technology. Mengo Hospital also has a dedicated
research and development team that works to find new solutions to health issues
in Uganda.
hospital in Uganda. It currently serves as an urban community hospital that
provides modern medical care. Mengo Hospital provides comprehensive care
including radiology, obstetrics, dentistry, orthopedics, and surgery.
Additionally, Mengo Hospital provides critical training and education to health
professionals through its various programs in midwifery and nursing, health
sciences, and laboratory technology. Mengo Hospital also has a dedicated
research and development team that works to find new solutions to health issues
in Uganda.
Job Summary: The Insurance
Liaison Officer will be actively contributing to the success of the following
key business outcomes; Client Satisfaction, Client Retention and Effective
Claims Management.
Liaison Officer will be actively contributing to the success of the following
key business outcomes; Client Satisfaction, Client Retention and Effective
Claims Management.
Key Duties and Responsibilities:
- Ensure authentic identification of insured
and corporate clients prior to accessing care. - Attend to client’s queries and complaints
ensuring that they are resolved in a timely manner and make record of any
related upcoming cases. - Initiate and follow through the entire
Pre-authorization process prior to admission to point of discharge of
patient, and in the case of an emergency within 24 Hrs of admission. - Follow up all Inpatient cases, ensure all
the required documentation has been done and properly recorded. - Follow up all the Pre- authorization cases
and provide timely feedback to Clients on limits/denied services as
stipulated by the respective Credit Clients MOUs. - Follow up the medical care given to
Insurance clients and ensure that it is in line with authorized services. - Provide timely feedback to Insurance
liaison officers on all admission cases and produce reports to that
effect. - Validation and verification of client
membership and entitlements (Benefits and Exclusions) prior to service
access and ensuring that all the Clients lists are available and updated. - Ensure that all the Claim forms that are
released are accurately filled by the Doctor, received, vetted and
properly recorded prior to the patient leaving MH premises; all these Claim
forms should be submitted to the Accounts Assistant- Client relations with
an accompanying Claim forms report. - Update all the Client Companies on all the
price list changes as and when they occur and negotiate with same
companies when Claims are disputed because of price discrepancies, track
and keep record of all the disputed/rejected Claims, until the rejections
are fully resolved and settled
Qualifications, Skills and
Experience:
Experience:
- The ideal candidate should hold a
Bachelor’s Degree in Business Administration, Health Care Administration,
Bachelors of Science in Nursing or any other related field - At least five years’ experience in similar
role preferably in hospital setting - Knowledge of group insurance (medical,
dental, vision, life and disability products) desired - Understanding of self-funded arrangement
and large group benefits - Professionalism, Clinical and analytical
evaluation of information - Ability to be resourceful when following
up regulatory issues - Have ability to work under pressure and
independently - Ability to establish and maintain good
client relationships, both internally and externally at all levels - Excellent teamwork, organization and
communication skills
How to Apply:
All suitably qualified and interested candidates with relevant qualifications
and experience should submit their application letters, detailed Curriculum
vitae, copies of academic certificates, practicing licenses where applicable
and valid contacts/email addresses of three (3) referees electronically at the
link below.
and experience should submit their application letters, detailed Curriculum
vitae, copies of academic certificates, practicing licenses where applicable
and valid contacts/email addresses of three (3) referees electronically at the
link below.
Deadline: Tuesday 10th April
2018 by 5.00pm
2018 by 5.00pm
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