The Ugandan Jobline

• Ensure that patients are covered for services being offered through
  checking finger prints, card validity and card ownership.
• Ensure patients are treated within their limits of cover
• Ensure that City Medicals does not treat expired/ineligible members.

• Ensure to seek authorization for procedures, admission, ambulance
  pickups/drops before the service is provided or given to the patient.
• Ensure receipt of documented authorizations from all insurance
  partners through emails or hand-written letters.
• Attaching approvals on every claim that requires authorization
  before submission to the claims office in Accounts.

• As the Claims officer you will be responsible for ensuring that
  insurance patients are well received, are given all the necessary
  information relating to their treatment, cover and are smoothly taken
  through the system (hospital) with minimum setbacks.
• Ensuring good customer care by all the team members

• Ensure all services are billed using the different billing systems.
  i.e. Tracksol, Smart, AAR, Sancare etc.
• For all claims billed off system a reimbursement should be sent and
  the authorizing person indicated.

• As a Claims Officer, you will have to go through the claim forms
  daily and see if they were properly billed and if they were fully filled
  and finalized as follows:
• Claims date
• Employee company /employer
• Employee name
• Patient phone number
• Diagnosis
• Key symptoms
• Proof of authorizations attached
• Services itemized and each billed individually
• Claims billed
• Signature : Patient & Doctor

• All claim forms must be posted and excelled for proper record
  keeping and reconciling.

• To always make sure that the insurance work station is kept clean
  and tidy.
• Always account for equipment received from the head of department.
• Attend all insurance team meetings as may be communicated by the
  head/supervisors.
• Any other duties as may be assigned by the supervisors.

• The ideal candidate must hold a Bachelor’s Degree in Accounting and
  Finance. Bachelor’s Degree in Nursing
• At least five years’ experience as a Claims Officer
• Willingness to work a flexible schedule and fill in when required
• Excellent communication skills
• Proficient computer skills
• Confidentiality.
• Good working knowledge of healthcare Insurance
• Accurate and precise attention to detail
• Ability to work well with management and staff at all levels

Related Jobs