The Ugandan Jobline

• 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

• 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

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