Claims Administrator

LocationBlackrock Health Hermitage ClinicJob PurposeAs a key member of the Finance Team, the Claims Administrator will work with the wider Finance Operations function to ensure the timely and accurate collation of both financial and clinical documentation to support with the claims process. The position will require frequent interaction with patient data, consultants, medical secretaries, clinical staff, and other key stakeholders. The position requires a participatory approach to the development of services and structures, embracing continuous quality improvement and the management of changes necessary to achieve organisational objectives.Job Background/ContextThe Hermitage Medical Clinic is a private hospital providing a full range of medical and surgical care across a broad spectrum of specialities. The Finance function has responsibility for the provision of financial management and reporting across all clinical and non-clinical areas of the hospital and is important in making a significant contribution, developing and maintaining best practice in management and financial accounting.Key Responsibilities  OperationsSourcing and collating the required clinical documentation for our end-to-end claims process to support with accurate claims submissions and follow-up queries to ensure payment is received for services provided by the hospital Working with the Billing, Claims, and Accounts Receivables Teams to ensure all documentation is delivered in a timely mannerHighlight and correct potential gaps in the existing workflows to minimise the lead time between the point of discharge and receipt of paymentHighlight/identify any potential gaps in pricing with regards to contractsResponsible for developing key relationships with relevant staff e.g. Medical Records, Ward Clerks to ensure all relevant billing paperwork is provided in a timely manner to assist with order-to-cash processesResponsible for the achieving financial KPI’s and ensuring the needs of the Department are met Other relevant tasks as identified/ allocated by the Head of Finance Operations and assigned individualsPromote a patient centred culture of openness and responsiveness to positive and constructive patient feedback and ensuring patient dignity, respect and choice is maintained in their care.  Learning and EducationTake personal responsibility for own professional development and keep up to date with evidence-based practice and research. Attend and participate in staff development programmes on an ongoing basis.Assist with the orientation and induction of new staff and be available to provide orientation as deemed necessary, helping them to integrate as members of the Unit team.Attend all mandatory training days and ensure that all mandatary training is in date.Comply with all HR system and policy requirements. Quality Improvement and Risk ManagementEnsure that there is compliance with all relevant Hermitage Medical Clinic guidelines, policies, procedures and relevant legislation and regulatory requirements. This includes responsibility for dealing with regulatory or professional bodies and inspections. Participate in the requirements of the hospital’s accreditation process.Participate in the requirements of the hospital’s risk management programme.Promote the delivery of a high standard of care to all patients. Encourage evidence-based practice and assist in the dissemination and implementation of research findingsEssential Criteria/ Knowledge/ Experience ·     2 years working in a healthcare setting ·      Working in a team environment ·      Experience in dealing with patients/customers   Skills/ Competencies as per the HMC Competency Framework ·     Self -starter·      High attention to detail·      Ability to analyse high volumes of information·      MS Excel and MS Word·      Relationship building with internal and external personnel·      Team player with the ability to work on own initiative·      Able to prioritise and multi-task ·      Process Based Approach·      Ability to work to deadlines·       Desirable Skills/ Knowledge/ Experience ·      Hospital, Finance, or Insurance experience   This Job Description is intended as a basic guide to the scope and responsibilities of the position and is subject to regular review and amendment. The role holder will be required to be flexible in this position and is expected to facilitate working additional hours on occasion, when requested.The Hermitage Clinic is an Equal Opportunities Employer