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Medical Billing Associate
Role Summary:
The medical billing associate role entails ensuring that all medical billing requirements from different partners are adhered to, and that all the requisite clinical and patient documentation is well captured in every invoice.
Responsibilities:
- Thoroughly review claims for errors, accuracy, and completeness, rectifying any issues before submission to insurance companies. Provide direct feedback to medical centers/providers on identified errors.
- Coordinate pre-authorization and eligibility verification processes, ensuring compliance with insurance guidelines. Train medical center staff on insurance guidelines and provide consultation for compliance.
- Ensure timely dissemination of changes and communications from insurance partners to all medical centers. Maintain accurate record-keeping of invoices and communicate limits/exclusions to service points based on insurance guidelines.
- Support medical centers by identifying capacity gaps and providing training in medical billing. Liaise with the credit team to review disputed claims and provide clinical justification for appeals to insurance.
- Professionally respond to queries from insurance partners or medical centers regarding billing. Timely circulate memos to clinicians and clinical coordinators on new insurance guidelines.
- Scrutinize rejected claims related to clinical issues, providing guidance and coaching to medical centers to minimize claim denials. Submit invoices through designated portals for processing.
Key requirements and attributes:
- Be a Clinical Officer at Penda.
- 1 year working experience at Penda.
- A great champion of Penda Way demonstrating strong leadership skills.
- A track record of great performance across all areas from the PR.
Acting Branch Manager
Role Summary:
As the Acting Branch Manager, you will work to ensure the overall performance of the branch. The role requires strong leadership, clinical knowledge, customer service skills, and a focus on operational efficiency to ensure the medical center’s success. To achieve this, the Acting Branch Manager will be required to build a high-functioning team.
Responsibilities:
- Leading and motivating the team.
- Conducting staff check-ins, providing feedback, and resolving performance issues.
- Mentoring departmental leaders and ensuring adequate shift planning.
- Ensuring clinical quality and patient safety through audits and feedback.
- Monitoring key metrics and documentation accuracy.
- Collaborating with quality improvement teams to enhance service delivery.
- Leading the team in delivering excellent customer service.
- Addressing patient feedback and managing wait times.
- Ensuring adherence to patient experience standards and continuous training.
- Meeting patient number targets without compromising care quality.
- Managing projects and initiatives to drive innovation and profitability.
- Overseeing marketing strategies, branch maintenance, and safety protocols.
Key requirements and attributes
- Registered Clinical Officer
- Must have been a Clinical Officer In Charge for at least 6+ months in Penda.
- Strong people leadership skills & excellent communicator.
- Possesses business acumen
- Must have outstanding patient interaction & Care skills.
- Track record at Penda of leading projects successfully in their branch.
- Great team player with a drive for results and enjoys collaborative work
- Lifelong learner dedicated to personal and professional development, embracing the Penda way in all aspects of healthcare delivery.
Clinical Coordinator Incharge
Role Summary:
Clinical Coordinator in charge is an experienced Clinical Coordinator and a great team player who provides leadership to a team of Clinical Coordinators and works collaboratively with them to ensure continuous quality provision to our patients. The Clinical Coordinator in charge is responsible for ensuring the Front desk department meets the operational standards within the Medical Centres and continually strives for outstanding patient experience, efficiency, and quality excellence, as indicated by Penda’s internal metrics.
Responsibilities:
- Guide, mentor and coach team members, championing adherence to SOPs and regulatory standards to maintain high-quality patient care.
- Lead departmental operations in collaboration with the BM in ensuring financial and process efficiency i.e Mtiba reconciliation and balancing of the cash box.
- Create a welcoming environment for patients, addressing complaints promptly and managing inquiries effectively to enhance patient experience.
- Facilitate seamless communication with other departments and external partners, ensuring confidentiality and efficient coordination for optimal patient care.
- Guide on various payment methods, ensure adherence to billing protocols, and handle documentation accurately.
- Participate in training sessions, adhere to company policies, and uphold Penda’s culture within the team and medical center.
- Optimize front desk workflow, handle and manage all incoming calls and external communications.
Key requirements and attributes
- Meet the basic qualifications of a Clinical Coordinator.
- 1 year working experience at Penda.
- A great champion of Penda Way demonstrating strong leadership skills.
- A track record of great performance across all areas from the PR.