Provider Reconciliation Officer
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Afia Concept Claims Settling Agency is hiring a full-time Provider Reconciliation Officer in Nairobi. The role validates healthcare claims and reconciles provider invoices, payments, remittances and account balances to support accurate settlements and resolve discrepancies.
- Full-time role focused on reconciling healthcare provider accounts.
- Reconciles adjudicated claims, invoices, payments, remittances and balances.
- Identifies overpayments, underpayments, duplicate payments and unmatched transactions.
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Afia Concept Claims Settling Agency is hiring a full-time Provider Reconciliation Officer in Nairobi. The role validates healthcare claims and reconciles provider invoices, payments, remittances and account balances to support accurate settlements and resolve discrepancies.
- Full-time role focused on reconciling healthcare provider accounts.
- Reconciles adjudicated claims, invoices, payments, remittances and balances.
- Identifies overpayments, underpayments, duplicate payments and unmatched transactions.
- Requires 2 years of experience and a BA/BSc/HND qualification.
- Collaborates with providers, claims, medical, finance and client teams.
AI job guide
Use this guide to check salary signals, requirements, documents, application steps and safety before you apply.
AI salary guide
Source salary availableThe source lists Never pay for any notarisation, certificate or assessment as part of any recruitment process. Confirm the final pay, benefits, contract terms and allowances directly with the employer before accepting an offer.
Can you qualify for this role?
- Required2+ years of relevant experienceThe job post includes a minimum experience signal.
- RequiredEducation or certification mentioned in the postThe captured text mentions education, a diploma, certificate, or licence.
- PreferredPractical evidence in internship, finance, Finance / Accounting / AuditThe tags and summary point to skills connected with this role.
- RequiredAvailability to work in NairobiThe vacancy is associated with this location.
- UnclearComfort with the Full Time contract termsConfirm hours, duration, probation and benefits at the original source.
Documents to prepare
- Likely requiredUpdated CV
- Role specificCover letter or short employer message
- OptionalProfessional references
- Role specificAcademic or professional certificates
- VerifyID or passport only after verifying the employer
Application tips for this job
- Place your strongest Provider Reconciliation Officer evidence in the first half of your CV.
- In your cover letter or employer message, connect your experience to Afia Concept Claims Settling Agency (ACS) and the role in Nairobi.
- Add concrete examples related to internship, finance, Finance / Accounting / Audit, ideally with measurable outcomes or clear responsibilities.
- Follow the instructions from MyJobMag Kenya; avoid sending documents to unofficial contacts or copied links.
- Confirm the deadline, interview location and employer contact before sharing personal documents.
- Prepare a polite question about pay, benefits and contract terms for later interview stages.
Source and safety check
- MyJobMag Kenya
- Original source link available
- Application method is clear
- Deadline not specified
- No major risk signal was detected in the captured text.
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Interview preparation
- What experience makes you a strong fit for this Provider Reconciliation Officer role in internship, finance?
- How have you handled responsibilities similar to those in this job post?
- Are you available to work in Nairobi under the listed contract or schedule?
- Prepare examples with clear responsibilities, tools used and measurable outcomes.
- Review the source and research Afia Concept Claims Settling Agency (ACS) before the interview.
Ask what the first priorities will be in the role and how success will be measured.
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Original source description
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contact us
Afia Concept Claims Settling Agency (ACS) is a forward-thinking healthcare consulting firm operating in East Africa, with headquarters in Nairobi, Kenya. Established to bridge the gap between healthcare infrastructure and accessible, high-quality services, ACS offers end-to-end solutions in healthcare facility design, health financing advisory, digital health, and operational management.
View All Jobs at Afia Concept Claims Settling Agency (ACS)
Provider Reconciliation Officer
Job Type: Full Time
Qualifications
- BA/BSc/HND
- Bachelor's Degree in Accounting, Finance, Business Administration, Economics, Insurance, Health Records, Healthcare Management, or a related field.
- Proficiency in Microsoft Excel and reconciliation systems.
Experience
2 years
Location: Nairobi
Job Field: Finance / Accounting / Audit
Role Purpose
The Provider Reconciliation Officer is responsible for ensuring accurate reconciliation of healthcare providers' accounts by validating claims, invoices, payments, recoveries, credit notes, and provider statements. The role plays a critical part in maintaining financial accuracy, supporting timely provider settlements, minimizing disputes, and fostering positive provider relationships.
Within a Third-Party Administration (TPA) environment, the incumbent serves as a key liaison between healthcare providers, claims teams, medical teams, finance teams, and clients to ensure that provider accounts accurately reflect services rendered, approved claims, payments made, and outstanding balances. The role requires strong analytical skills, attention to detail, and a thorough understanding of healthcare claims processing and provider payment cycles.
Minimum of 2 years' experience in healthcare finance, claims management, provider reconciliation, medical insurance, managed care, or a related field.
Experience working within a TPA, health insurer, managed care organization, or healthcare administration environment is preferred.
Check how your CV matches this job
Method of Application
- Interested and qualified? Go to
- Afia Concept Claims Settling Agency (ACS) on www.acs.co.ke
- to apply
- Build your CV for free.
- Download in different templates.
Key Accountabilities
- Provider Account Reconciliation
- Perform regular reconciliation of provider statements against adjudicated claims and payment records.
- Verify the accuracy of provider invoices, statements, remittances, and account balances.
- Match approved claims against payments made to healthcare providers.
- Review provider accounts to identify discrepancies, overpayments, underpayments, duplicate payments, and unallocated transactions.
- Investigate and resolve unidentified or unmatched transactions.
- Maintain accurate reconciliation schedules and supporting documentation.
- Claims and Payment Verification
- Validate claims included in provider invoices prior to payment processing.
- Reconcile approved claims against contractual payment schedules and approved tariffs.
- Verify deductions, recoveries, reversals, and adjustments applied to provider accounts.
- Review rejected and partially settled claims and ensure proper documentation.
- Ensure all payment records are accurately reflected in reconciliation reports.
- Collaborate with Claims and Finance teams to address payment variances.
- Provider Query and Dispute Resolution
- Respond promptly to provider enquiries relating to invoices, payments, deductions, recoveries, and account balances.
- Investigate provider disputes and reconciliation exceptions.
- Liaise with relevant internal departments to obtain supporting documentation and resolutions.
- Maintain records of provider disputes and resolution actions.
- Follow up on open reconciliation issues until closure.
- Ensure timely communication with providers regarding outstanding matters.
- Financial Control and Risk Management
- Identify financial discrepancies and escalate material risks appropriately.
- Monitor ageing balances and unresolved reconciliation items.
- Support recovery of overpayments and identification of duplicate claims.
- Ensure compliance with reconciliation controls and financial procedures.
- Assist in prevention and detection of billing irregularities and fraudulent claims.
- Contribute to initiatives aimed at improving payment accuracy and financial controls.
- Provider Relationship Management
- Maintain professional working relationships with healthcare providers.
- Participate in provider engagement meetings where reconciliation issues are discussed.
- Support initiatives aimed at improving provider satisfaction and payment transparency.
- Promote effective communication between providers and internal stakeholders.
- Facilitate resolution of provider concerns through collaborative engagement.
- Reporting and Documentation
- Prepare daily, weekly, and monthly reconciliation reports.
- Generate exception reports highlighting unresolved discrepancies.
- Maintain comprehensive reconciliation records and supporting documentation.
- Monitor reconciliation trends and recurring issues.
- Provide reconciliation updates to management as required.
- Support month-end and year-end financial reporting processes.
- Process Improvement
- Identify gaps and inefficiencies within reconciliation processes.
- Recommend improvements to enhance reconciliation accuracy and efficiency.
- Participate in process improvement projects and system enhancement initiatives.
- Support implementation of new controls, procedures, and reconciliation tools.
- Contribute to continuous improvement of provider settlement processes.
- Compliance and Governance
- Ensure compliance with organizational policies and procedures.
- Adhere to contractual agreements with healthcare providers.
- Maintain confidentiality of provider, client, and member information.
- Support audit exercises by providing reconciliation documentation and reports.
- Ensure compliance with regulatory and industry requirements.
- Promote adherence to ethical and professional standards.
- Key Performance Indicators
- Provider Reconciliation Accuracy
- Timeliness of Reconciliation Completion
- Provider Query Resolution
- Outstanding Reconciliation Item Resolution
- Claims and Payment Matching Accuracy
- Provider Dispute Resolution
- Compliance with Reconciliation Procedures
- Accuracy and Timeliness of Reconciliation Reports