Job Openings at Emel Hospital Limited

Description 

• Responsible for business development and thorough building and maintaining professional relationships with other hospitals (referrals), HMOs, organizations, private individuals etc.
• In charge of identifying and leading the tender process on new opportunities.
• Develop a growth strategy focused both on financial gain and customer satisfaction
• Identifying and penetrating new profitable markets.
• Building and maintaining relationships with individuals, startups, NGOs, SMEs for the purpose of creating and strengthening business alliances that complement the organization’s core competencies
• Negotiating and winning businesses the hospital thereby contributing towards the achievement of team and departmental targets
• Ensuring existing and potential clients are offered professional and quality service to increase sales and patronage
• Maintaining and developing relationships with new and existing customers in person and via telephone calls and emails.

Requirements

• Interested candidates should possess an HND with 3 - 5 years work experience.

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Description 

• Examine bills and claims from using the agreed Tariff to ensure authenticity.
• Ensure bills are vetted before sending them to HMOs
• Ensure diagnosis matches with treatment
• Request for both payment advice and schedule from HMOs
• Ensure Authorization codes are received as appropriate for all secondary healthcare
• Ensure the lists of registered enrollees from HMOs are updated or ensure the enrollee's status is verified before treatment.
• Investigate suspicious claims through Enrollee contact, case folder checks and other approved protocols
• Escalate complicated fraudulent claims to the management.
• Forward approved Claims to Clinical Director for review and final approval.
• Participate in the resolution of medical claims cases requiring rigorous negotiations

Requirements

• Interested candidates should possess an HND with 3 - 5 years work experience.