Mini Group is a dynamic, multi-industry conglomerate with a strong presence across East Africa. We are seeking a Medical Administrator for Billing & Clinical Administration based in Nairobi. The role is responsible for accurate charge capture, patient billing, insurance claims processing, financial reconciliation, and clinical administrative support to ensure smooth revenue cycle operations and efficient patient flow.
Key Duties & Responsibilities
Billing & Revenue Cycle Management
- Capture patient charges accurately across consultations, procedures, pharmacy, laboratory, and consumables.
- Prepare and issue invoices, receipts, and statements through computerized healthcare systems.
- Ensure complete charge capture to minimize revenue leakage across all service lines.
- Reconcile daily billing transactions against clinical services delivered and maintain accurate electronic billing records within the EHR system.
Insurance Claims Management
- Process insurance claims for the Social Health Authority (formerly NHIF) and private medical insurers.
- Verify patient eligibility, benefit coverage, and pre-authorization requirements before service delivery.
- Ensure correct coding of diagnoses, procedures, and medical services for compliant claims submission.
- Submit claims within required timelines and follow up on approvals, rejections, pending codes, and documentation gaps.
Clinical Administration & Controls
- Ensure accurate entry and complete closure of patient records within the EMR system.
- Support clinicians in maintaining complete documentation required for billing and insurance approval.
- Verify alignment between clinical notes, prescriptions, diagnostic investigations, and final billed services.
Cashiering & Financial Reconciliation
- Process patient payments securely across cash, card, and mobile money channels.
- Maintain daily cash reconciliation, banking records, and support internal financial audit readiness.
Departmental Coordination
- Coordinate with pharmacy and laboratory teams to ensure all diagnostics, dispensed items, and consumables are captured and billed correctly.
- Work with clinicians to resolve missing, unclear, or incomplete documentation affecting billing or claims processing.
- Support efficient patient flow and reduced waiting time through active administrative and queue coordination.
Compliance & Audit Support
- Ensure compliance with SHA/NHIF regulations, private insurer requirements, institutional billing policies, patient confidentiality standards, and data protection regulations.
- Participate in internal and external financial, insurance, and clinical documentation audits.
Qualifications & Experience
- Diploma or Bachelor’s Degree in Health Records, Business Administration, Finance, or a related field from a recognized institution.
- Minimum 2–3 years’ progressive hands-on experience in hospital billing, health records tracking, or medical insurance administration.
- Strong working knowledge of SHA/NHIF processes, medical coding frameworks, and private medical insurance systems within Kenya.
- Demonstrated experience working with Electronic Health Records and hospital billing or inventory modules.
Key Skills & Competencies
- Strong understanding of healthcare billing, insurance verification, and hospital revenue cycles.
- Up-to-date knowledge of SHA/NHIF rules, claims validation processes, and private insurer reimbursement structures.
- High attention to detail, numerical accuracy, and reconciliation skills.
- Strong interpersonal communication and coordination skills across clinical, pharmacy, laboratory, and finance teams.
- Ability to multitask and work under pressure in a fast-paced, high-volume outpatient clinic environment.
- High professional ethics, financial accountability, confidentiality, and commitment to data protection.
How to Apply
Interested and qualified candidates should apply online by visiting Mini Group on minigrp.com.
