Key Responsibilities
Billing & Claims Management
Develop, implement, and enforce policies that ensure the accuracy and completeness of patient billing information
Oversee timely submission of clean claims to insurance providers, corporates, and government schemes (including SHA)
Investigate and resolve claim denials, underpayments, and billing errors, implementing corrective action to reduce recurrence
Monitor billing error rates and drive continuous improvement towards industry benchmarks
Insurance & Corporate Accounts
Maintain and Manage relationships with insurance companies and corporate clients
Negotiate and maintain up-to-date knowledge of payer contracts, fee schedules, and pre-authorisation requirements
Liaise with payers to resolve disputes, verify eligibility, and follow up on payer commitments
Team Leadership & Department Oversight
Lead, supervise, and develop the revenue cycle team including billing staff, coders, and collections officers
Set performance targets, conduct appraisals, and identify training needs
Foster a culture of accuracy, accountability, and patient-centred service
Metrics, Reporting & Analytics
Track and report on key performance indicators including denial rates, first-pass resolution rates, clean claim rates, and admission/discharge turnaround times
Prepare regular revenue cycle reports for the Finance Director and senior management
Identify trends and recommend operational or policy changes to optimize revenue capture
Process Improvement & Compliance
Implement policy changes to reduce claim errors and shorten the revenue cycle
Ensure compliance with healthcare billing regulations, insurance contractual obligations, and internal financial controls
Collaborate with clinical, front-office, and finance teams to close gaps at the point of patient registration and discharge documentation
Requirements
Qualifications & Experience
Diploma or BsC in Nursing, Bachelors degree in finance, Accounting, Health Information Management, or a related field
4 - 6 years of progressive experience in a hospital and/or insurance setting with at least 2 years in a supervisory capacity
Strong working knowledge of insurance and care billing processes and relationship management
Proficiency in Hospital/Health Management Information Systems (HMIS) and billing software
Familiarity with SHA, private insurance and corporate care protocols.
Key Competencies
Analytical thinking and attention to detail
Strong communication and negotiation skills
Leadership and team development
Process improvement orientation
Financial acumen and understanding of healthcare operations