KEY RESPONSIBILITIES:

• Patient Billing Duties:

• Prepare accurate and timely bills for inpatient, outpatient, emergency, laboratory, pharmacy, radiology, and other hospital services.
• Verify that all services, medications, procedures, and consumables are correctly captured before billing.
• Review patient accounts to ensure billing information is complete and accurate.
• Generate invoices, receipts, credit notes, and other billing documents as required.
• Correct billing errors and discrepancies in coordination with relevant departments.
• Ensure all billing activities are completed within established turnaround times.

• Insurance and Corporate Billing Duties:

• Prepare and process insurance and corporate client claims in accordance with contractual requirements.
• Verify patient insurance eligibility and coverage before claim submission.
• Submit insurance claims accurately and within required timelines.
• Follow up on outstanding insurance claims and coordinate the resolution of rejected or disputed claims.
• Maintain proper documentation supporting insurance and corporate billing transactions.
• Reconcile insurance payments against submitted claims.

• Revenue Collection and Account Reconciliation Duties:

• Monitor outstanding patient and insurance balances.
• Follow up on unpaid invoices and outstanding accounts.
• Reconcile billing records with payments received.
• Assist in identifying billing discrepancies and revenue leakage.
• Support month-end reconciliation of billing transactions and accounts receivable.
• Maintain accurate records of collections and outstanding balances.

• Billing Administration and Record Management Duties

• Maintain complete, accurate, and confidential billing records.
• Ensure proper filing and documentation of billing transactions.
• Update billing information in the Hospital Information System (HIS) and other financial systems.
• Prepare daily, weekly, and monthly billing reports.
• Assist with month-end and year-end billing activities.
• Ensure compliance with document retention requirements.

• Customer Service Duties

• Respond to patient, insurance, and corporate client inquiries regarding billing and payments.
• Explain billing charges, payment procedures, and insurance coverage to patients when required.
• Resolve billing-related complaints professionally and promptly.
• Coordinate with clinical departments to clarify billing information and resolve discrepancies.
• Maintain confidentiality of patient financial information.

• Compliance and Quality Assurance Duties

• Ensure compliance with hospital billing policies, financial procedures, and applicable Ethiopian laws and regulations.
• Follow internal control procedures related to billing and revenue collection.
• Assist internal and external auditors by providing required billing documentation.
• Report suspected billing errors, fraud, or irregularities to the Billing Manager or Finance Manager.
• Participate in continuous quality improvement initiatives related to billing operations

• Other Duties as Required:

• Participate in departmental meetings and training programs.
• Support revenue cycle improvement initiatives.
• Assist other finance team members during peak workloads.
• Perform other duties assigned by the Billing Manager, Finance Manager, or senior management.

REQUIRED MINIMUM QUALIFICATIONS:

• Bachelor's Degree in Accounting, Accounting and Finance, Finance, Business Administration, Health Information Management, Healthcare Administration, or a related field.
• Minimum of three (3) years of relevant experience in billing, finance, accounting, accounts receivable, or revenue cycle management.
• Experience in hospital or healthcare billing is highly preferred.
• Experience working with insurance claims and corporate billing is an advantage.

KNOWLEDGE, SKILLS AND ABILITIES:

• Good knowledge of hospital billing processes and revenue cycle management.
• Understanding of insurance claim processing and reimbursement procedures.
• Basic knowledge of Ethiopian tax regulations and financial compliance requirements.
• Strong numerical, analytical, and problem-solving skills.
• Proficiency in Hospital Information Systems (HIS), Electronic Medical Records (EMR), billing software, and Microsoft Office applications, particularly Excel.
• Excellent communication, customer service, and interpersonal skills.
• Strong organizational skills with attention to detail and accuracy.
• Ability to work under pressure, manage multiple priorities, and meet deadlines.
• High level of integrity, confidentiality, and professional ethics.
• Ability to work effectively both independently and as part of a multidisciplinary team.