OUTPATIENTS CLERK x 2 – PERMANENT

This position will be reporting to the Medical Services Administrator. The successful candidate will be responsible for the following:

Key Responsibilities

• Invoicing, collection of outstanding patient accounts and maintaining customer accounts
• Supports Medical Services Administration through efficient communication related to benefits queries, sick leave and in-hospital status
• Maintain system for storage and archive of patient records.
• Promotes a culture of ethical care of patients and continuous improvement
• Complete clerical duties including answering phones, scheduling appointments, responding to emails, and processing patient admission and discharge records.
• Create, maintain, duplicate, track, match, and purge patient medical records and files in accordance with established procedures.
• Support the CMO and medical officer in responding to requests for medical records and processing letters and reports.
• Distribute patient medical records to the appropriate departments of the hospital.
• Maintain discharged patient records filing system in an accessible manner for prompt retrieval of records.
• Schedule and book medical referral appointments to external health care providers and make necessary arrangements for transportation and payment guarantees.
• Scan and digitize paper records into electronic health record systems.
• Compile and reconcile reports on daily patient transactions.
• Use computer applications or other automated systems to process business transactions such as initiating transport vouchers for referred patients, processing digital and cash transactions, issuing receipts, preparing bank deposits, general ledger postings and statements.
• Maintain patient accounts using an automated billing system that uses codes to facilitate reimbursement from debtors such as medical aid schemes, national health insurance (NHI), contractors, etc.
• Inform and collect, where applicable, shortfall expenses from medical aid scheme members before treatment is rendered
• Liaise and verify with the medical team, patients, or other responsible people as necessary to ensure accuracy of hospital charges against established rates for diagnosis, treatment, services, and supplies.
• Submit claims to a variety of payment sources including medical aid, NHI, in-house health care scheme, and other third-party reimbursors (contractors). Ensure that all medical aid or health insurance claims are submitted within the regulated time frame (no later three months)
• Ensure that all claims' rejections are promptly dealt with in the regulated time frame (no later than three months)
• Hand over unpaid accounts to the Medical Services Administrator for further collection in line with the business unit’s policy on such accounts.
• Accurately record the collection status and relevant collection notes for each account on the system or provided spreadsheet for management reporting purposes.
• Collect medical and patient data such as diagnosis, treatment, proof of eligibility, and health care insurance (medical aid, NHI, in-house health care scheme) verification.
• Maintain communication with patients and third-party payers until accounts are paid.
• Maintain a safe, clean, and welcoming patient waiting area, at all times.
• Assist hospital staff, patients, and their families/visitors, providing information and directions.
• Re-order office supplies and replenish stock to maintain an adequate inventory of supplies and ensure timely receipt of supplies.

Qualifications and Experience

• Full grade 12 Certificate.
• Certificate in Records Management
• Relevant Diploma or Certificate (AAT, Diploma in Commerce, Bookkeeping etc.)
• Preferably 1-2 years' experience as a Debtors' Clerk
• Customer Service
• Proficiency with the use of Microsoft Office
• Experience with using Accounting Systems
• Working knowledge of SAP
• Experience with medical insurance, familiarity with ICD medical coding, knowledge of medical authorisation procedures.
• Attention to detail and problem-solving skills
• Excellent written and verbal communication skills
• Strong numeracy, organization and planning skills
• Excellent time management skills and ability to multi-task and prioritize work
• Suitably qualified applicants must provide certificates verified by Zambia Qualifications Authority (ZAQA).

• Invoicing, collection of outstanding patient accounts and maintaining customer accounts
• Supports Medical Services Administration through efficient communication related to benefits queries, sick leave and in-hospital status
• Maintain system for storage and archive of patient records.
• Promotes a culture of ethical care of patients and continuous improvement
• Complete clerical duties including answering phones, scheduling appointments, responding to emails, and processing patient admission and discharge records.
• Create, maintain, duplicate, track, match, and purge patient medical records and files in accordance with established procedures.
• Support the CMO and medical officer in responding to requests for medical records and processing letters and reports.
• Distribute patient medical records to the appropriate departments of the hospital.
• Maintain discharged patient records filing system in an accessible manner for prompt retrieval of records.
• Schedule and book medical referral appointments to external health care providers and make necessary arrangements for transportation and payment guarantees.
• Scan and digitize paper records into electronic health record systems.
• Compile and reconcile reports on daily patient transactions.
• Use computer applications or other automated systems to process business transactions such as initiating transport vouchers for referred patients, processing digital and cash transactions, issuing receipts, preparing bank deposits, general ledger postings and statements.
• Maintain patient accounts using an automated billing system that uses codes to facilitate reimbursement from debtors such as medical aid schemes, national health insurance (NHI), contractors, etc.
• Inform and collect, where applicable, shortfall expenses from medical aid scheme members before treatment is rendered
• Liaise and verify with the medical team, patients, or other responsible people as necessary to ensure accuracy of hospital charges against established rates for diagnosis, treatment, services, and supplies.
• Submit claims to a variety of payment sources including medical aid, NHI, in-house health care scheme, and other third-party reimbursors (contractors). Ensure that all medical aid or health insurance claims are submitted within the regulated time frame (no later three months)
• Ensure that all claims' rejections are promptly dealt with in the regulated time frame (no later than three months)
• Hand over unpaid accounts to the Medical Services Administrator for further collection in line with the business unit’s policy on such accounts.
• Accurately record the collection status and relevant collection notes for each account on the system or provided spreadsheet for management reporting purposes.
• Collect medical and patient data such as diagnosis, treatment, proof of eligibility, and health care insurance (medical aid, NHI, in-house health care scheme) verification.
• Maintain communication with patients and third-party payers until accounts are paid.
• Maintain a safe, clean, and welcoming patient waiting area, at all times.
• Assist hospital staff, patients, and their families/visitors, providing information and directions.
• Re-order office supplies and replenish stock to maintain an adequate inventory of supplies and ensure timely receipt of supplies.

• Customer Service
• Proficiency with the use of Microsoft Office
• Experience with using Accounting Systems
• Working knowledge of SAP
• Experience with medical insurance, familiarity with ICD medical coding, knowledge of medical authorisation procedures.
• Attention to detail and problem-solving skills
• Excellent written and verbal communication skills
• Strong numeracy, organization and planning skills
• Excellent time management skills and ability to multi-task and prioritize work

• Full grade 12 Certificate.
• Certificate in Records Management
• Relevant Diploma or Certificate (AAT, Diploma in Commerce, Bookkeeping etc.)