Qualifications & Requirements
Applicants must meet the following requirements:
Diploma or Degree in Clinical Medicine, Business Administration, Finance, Health Records, or any other relevant field
Minimum of five (5) years' relevant experience as a Claims Officer or Credit Controller in a busy hospital setting
Strong and proven knowledge of SHA (Social Health Authority) and private insurance claims processes
Demonstrated experience in credit control, revenue cycle management, and debt recovery in a healthcare environment
Strong leadership skills with ability to supervise, guide, and develop a team
Experience in handling claim escalations, rejections, reconciliations, and insurer negotiations
Strong analytical, financial, and reporting skills
Proficiency in hospital management systems and insurance billing workflows will be an added advantage
High level of accuracy, integrity, accountability, and attention to detail
Excellent communication, negotiation, and stakeholder management skills
Ability to work under pressure and meet strict financial and reporting deadlines
Key Responsibilities
The successful candidate will be expected to:
Oversee the hospital's credit control and claims management function
Supervise claims officers and ensure timely submission, follow-up, and resolution of insurance claims
Monitor and manage hospital debtor accounts, ensuring timely recovery of outstanding balances
Liaise with SHA and private insurers to resolve claim queries, rejections, and payment delays
Review and approve claims submissions for accuracy, completeness, and compliance
Develop and implement credit control policies, procedures, and reporting frameworks
Prepare regular reports on claims performance, outstanding debts, and revenue cycle efficiency
Support pre-authorization, billing validation, and insurance verification processes
Ensure compliance with insurance policies, hospital procedures, and regulatory requirements
Drive continuous improvement in claims turnaround time and revenue collection efficiency
Provide leadership, training, and mentorship to the claims and billing team