Job Summary:The ideal candidate will be a qualified medical doctor with 3-5 years of experience in the insurance industry and/or hospital setting. This role requires a deep understanding of ICD and CPT coding, medical billing guidelines, and proficiency in managing insurance claims.The Assistant Insurance Manager will play a key role in ensuring accurate and efficient processing of insurance claims, while also supporting the insurance department in various administrative tasks.Key Responsibilities:Oversee and manage the day-to-day operations of the insurance department including the submission, resubmission, and follow-up of insurance claims.Ensure accurate coding of medical services using ICD and CPT codes in compliance with current medical billing guidelines.Collaborate with medical staff, finance, and IT teams to resolve discrepancies and optimize the billing process.Conduct audits of medical claims to identify and correct errors, ensuring compliance with insurance policies and regulations.Develop and maintain detailed reports using Excel to monitor claim status reimbursement trends, and department performance.Create and deliver presentations using PowerPoint to communicate key insights andupdates to senior management.Assist in the training and development of insurance department staff on billing procedures and guidelines.Stay updated with changes in insurance policies, medical coding standards, and billing regulations to ensure compliance.

Job Description:We are seeking a skilled IT Systems Administrator to join our team. The ideal candidate will have expertise in Hyper-Converged Solutions, UNIX and Microsoft Windows environments, network security, IP Telephony, switch and router management, wireless networking, and help desk management.Responsibilities:Hyper-Converged Solutions:Implement and manage hyper-converged infrastructure solutions for optimal performance and efficiency.Operating Systems:Administer UNIX and Microsoft Windows environments, ensuring smooth operation and resolving any system-related issues including the Backup and Disaster recovery planning.Network Security:Design, implement, and monitor network security measures to protect against unauthorized access and data breaches.Administering the Firewall and Email security solutions.Telecommunications:Manage IP Telephony systems, ensuring seamless communication and addressing any telephony-related challenges.Network Infrastructure:Oversee the configuration and management of switches, routers, and wireless networking to maintain a robust and secure network infrastructure.Help Desk Management:Provide efficient and effective help desk support, addressing user issues, troubleshooting, and escalating as necessary.Qualifications:Electronic or Computer Science Graduate or Post graduate with minimum 10-15 years of ExperienceProven experience in administering hyper-converged solutions, UNIX, and Microsoft Windows environments.In-depth knowledge of network security principles and best practices.Hands-on experience with IP Telephony systems and switch/router management.Proficiency in wireless networking configuration and management.Strong understanding of help desk management processes.Relevant Technical certifications (Cisco, Microsoft,VMware,Nutanix) and CISM/CISSP/CEH certification would be advantageous.Excellent problem-solving skills and the ability to work in a fast-paced environment.

JOB SUMMARYThe Senior Oracle Software Developer works under general supervision of the Team Lead Software Development and Manager-IT for the design, development, integration and maintenance of the Hospital’s HMIS and other software modules in accordance with IT department policies & guidelinesDUTIES & RESPONSIBILITIES1. Develops/modifies approved new/current HMIS modules with the aim of solving business problems or automating business processes to improve controls and operational efficiency.2. Assists in the development of interfaces between HMIS and ERP and provides on-going support.3. Coordinates with Team Lead and IT manager to resolve issues related to oracle HMIS systems and provides support for HMIS.4. Analyzes user requests for changes or enhancement to existing software, proposes architecture and design solutions for discussion with Manager-IT5. Maintains accurate quality control documentation and prepares project progress reports.6. Attends telephonic inquiries for assistance with the system. Diagnoses and trouble-shoots day-to-day problems faced by end users; analyzes and recommends ‘fixes’ to solve reported problems.7. Attends to end-users in person, as required, for identification of issues and provides solutions to minor problems in minimum possible time.8. Makes presentation or demonstrates software solutions to operational users.9. Provides training to end users in the usage of new, enhanced or modified software/ systems.10. Interacts with users through various phases of design, development, implementation & maintenance.11. Maintains daily work progress and time spent on various activities on the assigned project through project charter id.12. Maintains appropriate Helpdesk records, reports and files on the update and deletion of data.13. Participates in review and update of Policies and Procedures manuals.14. Attends departmental and committee meetings as required.15. Performs such other duties as may be assigned.

JOB SUMMARYThe Registrar– ER coordinates and administers Emergency Room services in accordance with Ministry of Health regulations, Hospital Medical Staff Bylaws, Rules & Regulations and Department Policy & Guidelines. Provides primary care to the host of patients entering Hospital ERs with illnesses and injuries covering a broad spectrum, from acute infections to life-threatening conditions.DUTIES & RESPONSIBILITIESOperational Duties1. Attends/Interviews all patients presenting to ER, provided they fulfill formalities of the ER department according to NMH policies & procedures2. Provides non-surgical care to patients; works with nurses and other emergency room staff to prioritize and evaluate cases3. Supervises clinical nurse’s work and answers to medical problem arising in the ER.4. Takes patient history, conducts physical examinations, requests and interprets other necessary investigations as the patient’s condition mandates5. Gives the necessary medical advice needed based on diagnosis; whether a prescription, medical management in ER, admission to the inpatient department, referral or transfer to another consultation facility.6. Performs medical procedures according to his/her clinical privileges7. Refers patients to a medical specialists or other practitioners as and when required8. Completes clinical notes of ER files and writes medical reports in consultation with the Consultant9. Decides and issues sick leave, according to MOH regulations and policies of NMHPatient Care10. Considers the patient’s safety as the first priority while working.11. Includes the patients in discussions concerning appropriate diagnostic and management procedures.12. Assesses, plans, implements and evaluates patient care needs.13. Maintains a work environment that promotes high standards for patient care and ethical behavior.14. Participates regularly with other department staff, in decision-making related to patient careCompliance with Medical Ethics15. Ensures implementation of the standard concepts, practices, and procedures within the field of Emergency Medicine.16. Exhibits appropriate personal and interpersonal professional behavior; practices medicine ethically and stays consistent with the obligations of a physician.17. Recognizes limits of personal skills and knowledge by appropriately consulting other Physicians while caring for the patient.18. Shows a pattern of maintaining current personal clinical skills and knowledge by continuing medical education.Other Duties19. Initiates continuous quality improvement programs for populations served20. Attends regularly scheduled meeting for the improvement of patient care services and delivery21. Participate actively in the Hospital educational program, clinical audits, and research22. Accepts all other additional assignments found necessary by the Clinical Director, Medical Director & Assistant Medical Director.

JOB SUMMARY:A Medical Claims Auditor reviews patients medical claims for accuracy& ensures that all medical claims are processed as per set procedures and hospital standards. Examine medical records, billing information, medical processes and regulation to identify inaccuracies, compliance issues and inefficiencies. The Auditor secures data integrity and maintains accurate standards by auditing eligibility criteria & services are performed in accordance with policy benefits & exclusions .DUTIES & RESPONSIBILITIES1. To perform & monitor on a daily basis all medical claims audit assuring treatment provided is in line with insurance policies terms & conditions.2. Assures that insurance claims are duly completed in accordance to the treatment.3. To Notify medical claims falling under general exclusions.4. Prepares monthly reports of claims, Audit’s key indicators with amount of claims individually mentioned.5. Perform re-submission of claims rejected due to medical reasons.6. Follow up with treating doctors & gets the precise justification to respond back to insurance companies.7. To Provide relevant justification reports along with insurance companies queries on case to case basis.8. Maintains, communicates, track and trend audit results and report findings.9. To Prepare monthly report of rejected claims resubmission showing the individual cost of claim resubmitted with medical justification.10. Assist with Claims Data Analysis and Quality Assurance as requested.11. Work collaboratively within the audit team as well as with internal and external customers.12. Prompt in identification and communication of recognized errors.13. Provides feedback to Manager, Claims Network and Information System departments of findings to improve quality.14. Attends meetings as required.15. Perform random quality audits of claims processed.

The Resubmission supervisor ensures the filing and tracking of insurance claims and informing patients of their claims status. Involved in Processing insurance and disability claims in a timely manner & prepares all insurance forms and associated correspondences. Analyzes the rejections, requests justifications & follow ups with the concerned doctors on regular basis for closure.DUTIES & RESPONSIBILITIES1. Liaises with treating physicians to receive properly completed justification of received rejections claim form requests for services which require approvals as per policy terms and conditions.2. Process the claims within a reasonable time frame within SLA and meeting the set KPIs;3. Handle relationships with clients and brokers regarding reimbursement claims by asking for additional information whenever required, by explaining the details of the settlements (i.e. application of the deductible and coverage, justify rejections and uncovered expense);4. Expedites the submission of Insurance claims, collection of receivables and resubmission of rejected claims.5. Adjudicate and approve justified claims within the policy limits set and to refer cases to the claims manager for approval where authority limits are exceeded.6. Interpret and process claims using knowledge of ICD codes, billing, benefits, and company policies.7. Proactively report critical issues to the Claims manager.8. Prepares periodic medical and financial rejection reports.9. Strives to reduce the amount of Rejected claims.10. Prepares monthly reports of claims, Audit’s key indicators with amount of claims individually mentioned.11. Follow up with treating doctors & gets the precise justification to respond back to insurance companies.(related to 1)12. To respond to and liaise as required with insurance companies and network providers in a professional and courteous manner.13. Assist with Claims Data Analysis and Quality Assurance as requested.14. Work collaboratively within the audit team as well as with internal and external customers.15. Provides feedback to Manager, Claims Network and Information System departments of findings to improve quality.16. Participates in weekly departmental meetings for updates and new processes.17. Enhances professional growth of self through participation in training programs, current literature and in service meetings18. Attends meetings as required.19. Performs other related duties as assigned by the Manager- Insurance.

The Sr. Management Accountant monitors & controls Financial reporting, Management reporting & Cost Accounting functions of the Hospital. He/ She ensures that all the Management reports (periodical, monthly & annual) are prepared & submitted on time to the Management. Develops various accounting policies & procedures, conducts project feasibility studies and handles financial liaisons.DUTIES & RESPONSIBILITIESFund Management & Budgeting1. Prepares Monthly, Periodical & Annual Financial Statements. Ensures that all the General Ledger accounts are reconciled, Balance confirmations obtained, Inter Company Accounts cleared and Balance Sheet Schedules maintained.2. Introduces Cost Ledger & Cost Accounting System for the Hospital; Cost classification in terms of Fixed/ Variable, Direct/ Indirect, Cost Analysis, Service Costing, identifies the wastages & advises Management on Cost Reduction strategies.3. Deals with Foreign Currency translations, procurement of best rates and identifies the Cash Resources of the Hospital4. Maintains sufficient balance in current account and channelizes surplus in short term deposits.5. Stands responsible for approving the preparation and release of Cheques.6. Deals with Treasury management; plans for payroll funds from the beginning of each month and day-to-day cash management7. Defines and controls the Pricing of Services/ Package, advises the Finance Manager & CFO on various Pricing Strategies.8. Conducts Project Feasibility studies with the objective of investing the Group resources profitably; identifies new investment opportunities, conducts Project appraisals & analysis.9. Prepares Strategic Budgets for the Hospital, Budget negotiation, approval, communication, implementation & initiates extensive Budgetary Control through the system.10. Supports Finance Manager in preparation of business plan, budget & reviews.Management Reports11. Compiles statistical, financial, accounts/ audit reports and tables pertaining to matters such as cash receipts, expenditures, accounts payable and receivable, and profits & losses12. Prepares Profitability Analysis, Statistical Analysis, Capacity Utilization Analysis etc., and conducts various Ratio Analysis to analyze and appraise Hospital performance.13. Prepares reports on :· Monthly/ periodical P & L Account, Balance Sheet, Cash Flow Statement.· Statement of Shareholders Equity.· Bank Reconciliation Statements.· Monthly Management Reports.· Cash Forecasts/ 3 months period/ 12 months period/ 36 months period.· Divisional/ Departmental Performance Report on a Monthly Basis.· Five Years Projections & forecasts for Financial Statements.· Reports assigned by Finance Manager & CFO from time to time.Financial System Application14. Familiarizes with the product functionality.15. Plans, schedules and oversees major software upgrades, new releases, and installation of related software applications.16. Develops documentation and training for end users on how to effectively use financial management system features and related applications.17. Access control of various users review and managementLiaising18. Liaisons with the Banks to deal with banking issues.19. Keeps track of the new services provided by the bank and maintains Internet banking accounts.20. Liaisons with other function managers to put the finance view in context.21. Handles Financial Liaisons with related parties & performs monthly Inter Company Current Account ReconciliationsOther Duties22. Manages Employee Incentive computation and processes payment. Participates in New Incentive scheme implementation.23. Attends Statutory Audits, Quarterly Audit reviews and complies with the Audit requirements.24. Develops various Accounting Policies & Procedures and Accounting Manual in accordance with the Internal Management rules & International Accounting Standards.25. Prepares Price List26. Maintains records of all price list updates27. Performs other related duties as assigned or requested by Finance Manager & CFO from time to time.

Operational Duties1. Treats and diagnoses ailments specific to the female reproductive organs2. Examines patients, performs and interprets diagnostic tests to obtain information on medical condition and determines diagnosis.3. Counsels patients on diet, hygiene, and preventive health care.4. Examines patients and determines x-ray examinations and clinical laboratory tests as required.5. Detects the presence of multiple births or birth defects through ultrasound.6. Conducts regular ward rounds independently and assists treating physicians during ward rounds.7. Assists in gynecological operations when required.8. Assists and attends deliveries either naturally or by cesarean section and ensures that the baby and mother are healthy. However, if it is required to deliver cases, he/she needs to take prior approval and perform the same under the supervision of the treating Consultant.9. Attends and assists normal and complicated deliveries; attends casualty cases, provides emergency treatment and performs the necessary admission procedures with the Clinical Director’s approval.10. Completes discharge files and statistics.11. Writes medical reports in consultation with the treating Consultant.12. Explains procedures and discusses test results or prescribed treatments with patients and families.13. Refers patients to medical specialist or other practitioner when necessary.Patient Care14. Considers the patient’s safety as the first priority while working.15. Includes the patients in discussions concerning appropriate diagnostic and management procedures.16. Participates in assessing, planning, implementing and evaluating patient care needs.17. Maintains a work environment that promotes high standards for patient care and ethical behavior.Compliance with Medical Ethics18. Ensure implementation of the Ministry of Health regulations, the Hospital Medical Staff Bylaws, Rules and Regulations and the Ob/Gyn. Department Policy and Guidelines.19. Ensures implementation of the standard concepts, practices, and procedures within the field of gynecology.20. Exhibits appropriate personal and interpersonal professional behavior; practices medicine ethically.21. Respects the opinions of department Consultants/Specialist and referring Physicians in the management of patient problems.22. Recognizes limits of personal skills and knowledge by appropriately consulting Specialists/ Consultants while caring for the patient.23. Shows a pattern of maintaining current personal clinical skills and knowledge by continuing medical education.Other Duties24. Participates in continuous quality improvement programs for Ob/Gyn. service25. Attends the meetings of the Ob/Gyn. department to discuss the rules & regulations, obstacles in work, incidents & complications encountered and suggestions to improve the quality of service.26. Participates regularly with other Ob/Gyn. staff, in decision-making related to patient care.27. Participates in organizational performance improvement activities.28. Accepts all other additional assignments found necessary by the Clinical Director- Ob/Gyn, Medical Director & Asst. Medical Director.