Insurance Check / Recovery Officer

About the role

The Insurance Check / Recovery Officer verifies patients' insurance coverage, processes claims and follows up on reimbursements so that the hospital recovers its revenue accurately and on time. The role requires close coordination with patients, insurance providers and internal hospital departments.

Key responsibilities

• Verify insurance eligibility and coverage for all patients before service delivery, guide them through requirements and co-payments, obtain pre-authorisations and communicate with insurers about benefits and exclusions.
• Prepare and submit claims (CBHI, RSSB, private insurers, employer schemes), review them for accuracy and compliance, track pending or rejected claims and reconcile payments with hospital accounts.
• Monitor insurance receivables, keep records of claims status and prepare daily, weekly and monthly reports on claim performance and recovery rates.
• Escalate recurring claim rejections to management and build good working relationships with insurers and corporate health schemes.
• Support patients with insurance queries and work with billing, finance and registration teams to streamline processes.

Required profile

• Bachelor's degree in Accounting, Finance, Business Administration or a related field.
• 2-4 years of experience in insurance claims processing or hospital billing.
• Strong knowledge of Rwanda's insurance systems (CBHI, RSSB and private insurers).
• Fluency in English and Kinyarwanda; French is an added advantage.

Required skills

• MS Office and hospital billing/claims management systems.
• Analytical, problem-solving and negotiation skills.
• Attention to detail, organisation, integrity and customer service.