Nairobi Adventist Hospital (NAH) is a faith-based, Seventh-day Adventist healthcare facility located in Nyari, Westlands, Nairobi County, Kenya. Committed to delivering affordable, high-quality, and compassionate healthcare, NAH has grown into a trusted primary care institution in the region. The hospital continually seeks to improve its services to better meet the needs of its clients.
In line with this commitment, NAH is inviting applications from qualified, competent, and dedicated professionals for the position of Claims and Billing Officer. This is an excellent opportunity for a healthcare finance professional looking to contribute to a values-driven healthcare institution and to grow within a dynamic work environment.
Position: Claims and Billing Officer
Location: Nairobi
Department: Finance and Billing
Reports To: Billing Manager
Job Purpose
The main purpose of the role is to ensure accurate and timely billing for patients under cash, private insurance, and SHA/SHIF (State Health Insurance Fund) cover. The position requires someone who can guarantee correct claims processing, manage billing inquiries, and work closely with internal departments and external partners to streamline the hospital’s financial operations.
Key Duties and Responsibilities
- Prepare billing statements for insurance companies, corporate clients, and cash-paying patients.
- Review discharge summaries for completeness and accuracy before generating billing statements.
- Analyze invoices and financial data; prepare related reports and respond to billing inquiries.
- Coordinate with physicians, nurses, and administrators to ensure pre-authorizations for SHIF and corporate clients are in place.
- Verify SHIF membership status and approvals; ensure biometrics are captured per the required procedures.
- Update inpatient and outpatient bills daily in coordination with internal billing units and external partners.
- Ensure all medical services rendered are properly billed and documented.
- Provide daily or on-demand billing updates to corporate and cash-paying clients.
- Conduct routine ward rounds to gather and update patient billing information.
- Validate insurance, corporate, and SHIF documents for authenticity and validity.
- Establish and monitor payment arrangements with patients; follow up on payment lapses.
- Discharge patients by finalizing their bills and issuing gate passes upon payment confirmation.
- Generate daily, weekly, and monthly billing reports for internal audits and reconciliations.
- Post or process all billing information into appropriate accounts using the hospital’s accounting system.
- Prepare physical SHIF invoices and claims with supporting documentation for submission within the credit period.
- Participate in periodic stocktaking activities.
- Ensure secure handling and storage of billing documents, Letters of Undertaking (LOUs), and Guarantees of Payment for corporate clients.
- Uphold the hospital’s reputation by adhering to professional ethics, hospital policies, and operational guidelines.
- Collaborate with insurance firms, SHIF, and other third-party players for timely follow-up and settlement of claims.
- Use the Electronic Tax Invoice Management System (ETIMS) to input all corporate invoices, generate corresponding receipts, and file them in receipt-number order.
- Perform any other duties assigned by the supervisor or hospital administration that are relevant to the role.
Qualifications and Experience
Educational Qualifications
Applicants should possess a Diploma or Bachelor’s Degree in one of the following or related fields:
- Accounting
- Finance
- Business Administration
- Health Records and Information Management
Professional Certifications (Optional but Preferred)
- CPA (Certified Public Accountant) – at least Part I or II
- ACCA (Association of Chartered Certified Accountants)
- CHRP (Certified Healthcare Revenue Professional)
Experience Requirements
- Minimum of 4 years’ experience in hospital billing, healthcare finance, or medical claims processing.
- Hands-on experience with SHIF and private insurance billing procedures.
- Familiarity with hospital billing systems and accounting software.
Key Skills Required
- In-depth knowledge of hospital billing processes and health insurance claim cycles.
- Understanding of SHIF and private insurance frameworks and coverage policies.
- Strong data entry and system proficiency in Microsoft Office and hospital billing software.
- Exceptional analytical and numerical skills for accurate financial analysis.
- Excellent verbal and written communication abilities.
- Outstanding interpersonal and customer service skills.
- Ability to manage multiple priorities, meet tight deadlines, and work efficiently under pressure.
Core Competencies
- Computer literacy
- Attention to detail
- Negotiation and persuasion skills
- Sound accounting acumen
- Clear and courteous communication
- Strong customer relationship skills
Why Join Nairobi Adventist Hospital?
- Work in a mission-driven environment rooted in Christian values and compassionate service.
- Be part of a healthcare team committed to clinical excellence and innovation.
- Experience a supportive and collaborative work culture that promotes professional growth.
- Contribute meaningfully to the health and wellness of the Nairobi community and beyond.
How to Apply
If you are a qualified candidate who shares NAH’s passion for holistic healthcare and excellence in service delivery, we encourage you to apply.
Application Process:
- Prepare the following documents:
- A Cover Letter
- A Curriculum Vitae (CV)
- Copies of Academic and Professional Certificates
- Merge all documents into one PDF file.
- Address your application to:
The Human Resources Manager
Nairobi Adventist Hospital
P.O. Box 41352-00100
Nairobi
- Email your application to:
[email protected] - Use the job title “Claims and Billing Officer” as the subject of your email.
Application Deadline: Before 5:00 PM on 20th May 2025
Late submissions will not be considered.
Nairobi Adventist Hospital is an equal opportunity employer. Only shortlisted candidates will be contacted.
