Revenue Assurance Manager

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
  

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