Job Title: Hospital Claims Officer
Organisation: Marie Stopes Uganda
Duty Station: Kampala, Uganda
About Organisation:
Marie Stopes Uganda (MSUG) is affiliated with MSI Reproductive Choices and is registered in Uganda as a local Non-Governmental Organization (NGO). Since launching in 1993, MSUG has grown to become one of Uganda’s largest sexual and reproductive healthcare providers, offering a wide range of high-quality, affordable, client-centred services. Our service delivery channels are adapted to fit the different contexts of each region to maximise opportunities for building sustainable platforms that can provide a lasting impact on the health outcomes of Ugandans.
Job Summary: Reporting to the Operations Coordinator, the Hospital Medical Claims officer oversees and coordinates all activities related to medical insurance claims, ensuring accurate and timely submission, follow-up, and settlement of claims. The role involves supervising the claims processing team, managing relationships with insurance providers, resolving claim denials or disputes, and ensuring compliance with hospital policies and payer regulations. The Claims officer plays a key role in optimizing hospital revenue and maintaining positive insurer relations.
Key Duties and Responsibilities:
- Claims vetting – Conduct daily claims and system audits to:
- Ensure that all clients who come to the hospital are billed correctly.
- Ensure that right entries are entered into E H R and the 3rd party billing systems.
- Ensure that the Day and Night invoices are vetted on a daily basis.
- Review claims for completeness, accuracy, and compliance with insurance and regulatory requirements.
- Invoice handling:
- Review interim bills daily and discharges and ensure creativeness of bills that meet the standards of insurance and cash patient. o Oversee billing, pricing and insurance claims management.
- Invoice submission and reconciliation.
- Supervise and coordinate daily operations of the claims department, including claim preparation, submission, follow-up, and reconciliation. o Ensure all claims are submitted accurately and within payer timelines to avoid rejections or delays.
- Investigate and resolve denied, underpaid, or delayed claims, coordinate appeals and resubmissions as necessary.
- Liaise with insurance companies, patients, and internal hospital departments to resolve claim issues.
- Liaison with Insurance Companies /stakeholder management-
- Review preauthorization forms for completeness/ justification and follow up on insurance response
- To make sure that all communication from invoicing companies is disseminated to the CLOs and all required parties in a timely manner e.g. new updated lists, off list and contract updates.
- Follow up on any queries as regards guarantees of payment, authorization requests and provide any other clarity
- required from insurance companies as required.
- Meeting attendance and representation
- Reporting:
- oWill provide a daily status report on service income split between posted invoices, pending invoices for different insurance companies, a status on all non-paid off transactions in E H R and means of resolution
- A report on variances between E H R, SMART and any other portal that an insurance company uses.
- Revenue collection analysis – compare lists EHR BI and actual revenue invoiced
- Orientation and Training:
- The Claims Officer shall ensure continuous training for CLOs and any other required personnels on EHR, SMART & insurance companies’ smart systems & will also provide induction and on-boarding for new staff on technical, non-technical, system related skills required for the job at hand.
- Devise Billing protocols & manuals, ensure alignment and compliance of teams
- Assets Custodianship
- Ensure effective custodianship and accountability for all assigned MSUG assets by implementing controls to prevent loss, theft or misuse of assets.
Qualifications, Skills and Experience:
- BSc or Diploma as a Clinical Officer or Registered Nurse
- Strong background and prior experience/ exposure to medical claims
- Strong knowledge of healthcare insurance processes, billing systems, and medical terminology.
- Excellent leadership, analytical, and problem-solving skills.
- Strong interpersonal and communication abilities for interacting with insurers, patients, and hospital staff.
Knowledge, Skills/ Experiences, and Abilities
- Excellent organisational skills and high attention to detail
- Analytical thinking and data interpretation
- Knowledge of healthcare regulations and insurance procedures
- Negotiation and conflict resolution skills
- Confidentiality and ethical conduct
- Demonstrated ability to balance multiple tasks and priorities
- Strong interpersonal skills that include an ability to work in team environment
- Good interpersonal/communication (both oral and written) and time management skills.
- Good working knowledge of Microsoft Office applications (MS Word, Excel, and MS Access)
- Three years of relevant hospital management experience or clinical setting.
- Four years in administration at managerial level.
How to Apply:
Submit your cover letter, CV, and academic documents as a single PDF file.
Clearly indicate the job title in the subject line of your email.
Send your application to [email protected].
Applications will be reviewed on a rolling basis; early submissions are encouraged.
Deadline: 15th December 2025
Note:
- MSUG is an equal opportunities employer, committed to safeguarding humanity and expects all position holders to share this commitment.
- MSUG has a well-guided and transparent recruitment process that requires no payment or sexual favours from any candidate/job applicants/potential job seekers as a pre-employment requirement.
- Qualified female candidates are encouraged to apply.
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Level of Education: bachelor degree
Work Hours: 8
Experience in Months: 48