Position
Summary

The Insurance Check / Recovery Officer will be
responsible for verifying patients’ insurance coverage, processing claims, and
following up on reimbursements to ensure timely and accurate revenue recovery
for the hospital. The role requires close coordination with patients, insurance
providers, and internal hospital departments to safeguard financial
sustainability and patient satisfaction.

Key
Responsibilities

Insurance
Verification & Pre-Authorization

• 
  Verify insurance eligibility and coverage for
  all patients before service delivery.
• 
  Guide patients through insurance requirements
  and co-payment obligations.
• 
  Obtain pre-authorizations where required and
  ensure accurate documentation.
• 
  Communicate with insurance providers to confirm
  benefits and exclusions.

Claims
Processing & Recovery

• 
  Prepare and submit insurance claims (CBHI,
  RSSB, private insurers, employer schemes) in a timely manner.
• 
  Review claims for accuracy, completeness, and
  compliance with insurance guidelines.
• 
  Track claim submissions and follow up on
  pending, delayed, or rejected claims.
• 
  Reconcile claim payments against hospital
  accounts and identify discrepancies.

Revenue
Assurance & Reporting

• 
  Monitor insurance receivables to ensure timely
  collection.
• 
  Maintain updated records of claims submitted,
  paid, pending, or rejected.
• 
  Prepare periodic reports (daily/weekly/monthly)
  on claim performance and recovery rates.
• 
  Escalate recurring claim rejection issues to
  management and recommend corrective actions.

Stakeholder
Engagement

• 
  Serve as the primary contact between the
  hospital and insurance providers.
• 
  Build and maintain good working relationships
  with insurers and corporate health schemes.
• 
  Provide support to patients regarding
  insurance-related queries.
• 
  Collaborate with billing, finance, and
  registration teams to streamline processes.

Requirements

Qualifications
& Experience

• 
  Bachelor’s degree in Accounting, Finance,
  Business Administration, or related field.
• 
  Minimum of 2–4 years’ experience in insurance
  claims processing or hospital billing.
• 
  Strong knowledge of Rwanda’s insurance systems
  (CBHI, RSSB, and private insurers).
• 
  Proficiency in MS Office and hospital
  billing/claims management systems.
• 
  Strong analytical, problem-solving, and
  negotiation skills.
• 
  Fluency in English and Kinyarwanda required;
  French is an added advantage.

Core
Competencies

• 
  Accuracy and attention to detail in claim
  preparation.
• 
  Strong organizational and time-management
  skills.
• 
  Integrity and accountability in financial
  transactions.
• 
  Customer service orientation and good
  interpersonal skills.
• 
  Ability
  to work under pressure and meet strict deadlines.