Vetting/Medical Claims Officer

Full Time
NFT Consults
Description

Client Summary:
Our Client is part of the healthcare cluster of CIEL Group, and is a leading healthcare provider in Uganda and the region, delivering the most caring medical expertise, always putting our patients first.

Position Summary:
This job is critical to accurate and complete billing of services in the organization; and the collection of payments for services rendered.

Duties and Responsibilities:

  • Review all medical and non-medical errors on each claim.
  • Ensure that all sections of all insurance claim forms are completed with no omissions.
  • Ensuring the doctor’s prescription matches the diagnosis and completeness of their signatures.
  • Ensure that all IPD and theatre claims/invoices are submitted with guarantees of payment attached.
  • Ensure that all Un-smarted claims are submitted with an off-smart authorization attached.
  • Ensure that all monthly claims of all insurance companies and corporates are fully submitted by the 2nd of every month.
  • Ensure that the invoiced/submitted amount per insurer matches the final reported system amount per month
  • Obtain remittance advice per insurer every month specifying paid amounts and rejected amounts per bill.
  • Make a summary of rejections per insurance company, invoice number, amounts, and patient names.
  • Classify all rejections into major reasons for rejection.
  • Identify justifications for medical rejections and correct errors on non-medical claims.
  • Identify reclaimable bills per insurer, re-submit, and attend reconciliation meetings with insurance companies.
  • Communicate common reasons for rejections with the responsible officers to avoid a repeat of the same.
  • Identify rejections due to negligence and attach to responsible officers for recovery
  • Compile a daily report on work done (invoices received, vetted and rejected) per biller and per insurer
  • Any other task that may be assigned to you from time to time

Qualifications and Experience:

  • A good first degree/diploma in clinical medicine.
  • Good and demonstrable understanding of IMG Philosophy, Vision and strategy (desirable)
  • Good interpersonal skills.
  • Good communication skills (Verbal & Written) to communicate effectively with clients, the team and other staff.
  • Good and demonstrable leadership skills (desirable)
  • Computer Literacy especially MS Office
  • Knowledge and ability to use Navision. (critical)
  • A good first degree or diploma with an accounting emphasis
  • Experience in a similar field is desired.

Deadline: 2026-08-31

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