Health Financing Assistant at MSI Reproductive Choices Kenya

Job Description

ABOUT THE ROLE

MSI Reproductive Choices Kenya is an NGO registered in Kenya as a local implementing partner of MSI Reproductive Choices, a UK charity. We deliver quality sexual and reproductive healthcare, family planning and other women’s health services to millions of the world’s poorest and most vulnerable women. We want to make sure that women have a choice when it comes to having children and that death by unsafe abortion is reduced.

We are seeking to recruit Health Financing Assistant on short term basis and will be responsible for accurate, timely, and compliant reconciliation of insurance payments and statements. He/She will be managing insurance receivables, verifying payment allocations, resolving discrepancies, and maintaining up to date insurance statements to support efficient revenue realization and financial reporting.

It is the responsibility of this role is to further our goal of MAKING CHOICE POSSIBLE for every Kenyan.

The post holder commits to and is held accountable to MSI Reproductive Choices core values:

• Mission Driven
• Client-Centered
• Accountable
• Courageous
• Resilience
• Inclusive

Responsibilities

1. Insurance Claims Vetting and Documentation

• Review claim forms across all centers to ensure accuracy, completeness, and compliance with insurer requirements.
• Verify supporting documents, approvals, and patient details before submission.
• Scan, organize, and archive claim forms and supporting documents for easy retrieval and audit purposes.
• Submit claims to the insurance for payment processing.

2. Claims Reconciliation and Billing Verification

• Reconcile claims submitted against services billed in the EHR and insurance billing systems to identify discrepancies and unbilled services.
• Verify billing accuracy, including services offered, charges, and contractual rates.
• Follow up on discrepancies and outstanding submissions to minimize revenue loss.

3. Insurance Systems and Claims Tracking

• Track claims through Smart, Smart EDI, LCT, Slade, OML SharePoint Portal, Mtiba, Starconnect, Henner, SHA portal as applicable.
• Update claims vetting and submission statuses in the EHR and maintain accurate records of outstanding claims.
• Identify and escalate system challenges affecting claims processing and submission.

4. Contract Compliance and Approvals

• Verify that billed prices align with agreed insurance contracts and approved tariffs.
• Ensure the required authorizations, approvals, and supporting documents are attached to claims.
• Monitor compliance with insurer requirements and internal procedures, addressing identified gaps with the relevant teams.

5. Center Support and Coordination

• Support centers with queries relating to client eligibility, billing, insurance approvals, and claims documentation.
• Liaise with center teams, IT, and relevant stakeholders to resolve insurance billing system challenges and operational issues.
• Communicate changes in insurance requirements and reinforce adherence to established processes.

6. Reporting and Process Improvement

• Prepare regular reports on claims submitted, outstanding items, billing discrepancies, and compliance gaps.
• Follow up on corrective actions and support improvements in claims accuracy, submission efficiency, and reimbursement.
• Maintain proper documentation to support audits, reconciliation, and management reporting.

7. Support During the HFO’s Maternity Leave

• Provide operational support to the existing HFA as they assume the HFO’s responsibilities during the maternity leave period.
• Assist with day-to-day insurance operations, claims management, and stakeholder coordination to ensure continuity of service delivery.

8. Corporate Business Development

• Support corporate business development initiatives in collaboration with the existing Health Financing Assistant (HFA) to grow and maintain insurance business across all centers.
• Coordinate with insurance providers and center teams to address operational challenges and strengthen service delivery.

Behaviours

Successful performance at MSIK is not simply defined in terms of ‘what’ people achieve but equally is about ‘how’ people go about their jobs and the impact that they have on others.

Work as One MSI

• You contribute, use, and share accurate data and evidence to improve understanding, insight and decision-making across MSI, enabling us to maximize our ability to influence others.
• You share relevant knowledge, expertise and resources to strengthen teamwork and prevent duplication of effort.
• You actively work as part of a team, providing support and flexibility to colleagues, demonstrating fairness, understanding and respect for all people and cultures.

Show courage, authenticity and integrity

You hold yourself accountable for the decisions you make and the behavior you demonstrate. You are courageous in challenging others and taking appropriate managed risks.

Develop and grow

• You seek feedback to enable greater self-awareness and provide the same to others in a way which inspires them to be even more effective.
• You manage your career development including keeping your knowledge and skills up to date.

Deliver excellence, always

• You strive to consistently meet and exceed expectations, putting clients at the centre of everything, and implement smarter, more efficient ways of performing your role.
• You build and maintain effective long-term working relationships with all stakeholders, and are a true MSI ambassador.

Leadership

• You inspire individuals and teams, through situational leadership, providing clear direction.
• You seek and provide opportunities which motivate team members, helping to develop skills and potential whilst strengthening our talent and succession pipeline.
• You are aware of emerging developments in our sector, demonstrating strategic insight about our clients and business and encourage this in your team.
• You articulate a vision of the future which inspires and excites others.

REQUIREMENTS

Qualifications

• Diploma or bachelor’s degree in finance, Accounting, Business Administration, or related field.
• At least 3 years’ experience in claims management with a reputable health organization.

Skills

• Minimum 2 year in office administration or accounting (Preferably in a hospital setting).
• Knowledge in claims management.
• Advanced proficiency in Microsoft Excel, including use of formulas, pivot tables, lookups, and data analysis tools for financial reconciliation and reporting.
• Demonstrated high attention to detail and ability to follow through tasks to completion.
• Good organization and prioritization skills.
• Ability to work with less supervision and initiative.
• Strong attention to detail and analytical skills.
• Excellent communication and coordination abilities.
• Prior experience in insurance or healthcare finance is an added advantage.