Insurance Liaison Officer Job Placement – Mengo Hospital
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.
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.
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:
- 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.
Deadline: Tuesday 10th April 2018 by 5.00pm
: List of Current Job Vacancies / Opportunities in Uganda