Valley Hospital is a leading Level 4 hospital in
Nakuru City offering both inpatient and outpatient services. We are seeking to
recruit a Revenue Assurance Manager to join our Finance Department.
He/She will play a crucial role in managing and
maximizing the hospital's revenue cycle by ensuring accurate billing, claims
processing, collections, and financial reporting. This position requires a
blend of financial acumen, client relationship management expertise, and a
basic understanding of clinical processes. The manager will oversee a team
responsible for revenue accounting, claims, admissions, and receivables,
ensuring a seamless flow of financial operations.
Interfaces with:
Financial Controller, Admission & Discharge Officers,
Credit Controller, Client Services, Credit Controller, Claims
Officers,
Key Responsibilities
Billing & Claims Management
- Develop,
implement, and enforce policies that ensure the accuracy and completeness of
patient billing information
- Oversee timely
submission of clean claims to insurance providers, corporates, and government
schemes (including SHA)
- Investigate
and resolve claim denials, underpayments, and billing errors, implementing
corrective action to reduce recurrence
- Monitor
billing error rates and drive continuous improvement towards industry
benchmarks
Insurance & Corporate Accounts
- Maintain and
Manage relationships with insurance companies and corporate clients
- Negotiate and
maintain up-to-date knowledge of payer contracts, fee schedules, and
pre-authorisation requirements
- Liaise with
payers to resolve disputes, verify eligibility, and follow up on payer
commitments
Team Leadership & Department Oversight
- Lead,
supervise, and develop the revenue cycle team including billing staff, coders,
and collections officers
- Set
performance targets, conduct appraisals, and identify training needs
- Foster a
culture of accuracy, accountability, and patient-centred service
Metrics, Reporting & Analytics
- Track and
report on key performance indicators including denial rates, first-pass
resolution rates, clean claim rates, and admission/discharge turnaround times
- Prepare
regular revenue cycle reports for the Finance Director and senior management
- Identify
trends and recommend operational or policy changes to optimize revenue capture
Process Improvement & Compliance
- Implement
policy changes to reduce claim errors and shorten the revenue cycle
- Ensure
compliance with healthcare billing regulations, insurance contractual
obligations, and internal financial controls
- Collaborate
with clinical, front-office, and finance teams to close gaps at the point of
patient registration and discharge documentation
Requirements
Qualifications & Experience
- Diploma or BsC
in Nursing, Bachelors degree in finance, Accounting, Health Information
Management, or a related field
- 5 years of
progressive experience in a hospital and/or insurance setting with at least 2
years in a supervisory capacity
- Strong working
knowledge of insurance and care billing processes and relationship management
- Proficiency in
Hospital/Health Management Information Systems (HMIS) and billing software
- Familiarity
with SHA, private insurance and corporate care protocols.
Key Competencies
- Analytical
thinking and attention to detail
- Strong
communication and negotiation skills
- Leadership and
team development
- Process
improvement orientation
- Financial
acumen and understanding of healthcare operations