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Revenue Assurance Manager Job Valley Hospital

Valley Hospital Nairobi 11 Jun
Accounting, Auditing & Finance full time
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Job description & requirements

Medical Jobs. Valley Hospital Jobs

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

Qualifications

  • 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

How to Apply

Click here to apply

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