Medical Billing & Coding Specialist

About the role

We are looking for a detail‑oriented Medical Billing and Coding Specialist to join our team in Westlands, Nairobi. You will be responsible for processing and submitting accurate medical claims while ensuring compliance with coding standards and insurance requirements.

Key responsibilities

• Accurately code and submit medical claims to insurance companies and third‑party payers.
• Verify patient information, insurance eligibility, and coverage before claim submission.
• Track claim status, follow up on unpaid or denied claims, and resolve billing discrepancies.
• Collaborate with the coding department to maintain compliant claim submissions.
• Assist patients by explaining billing processes, payment options, and account balances.
• Process patient and insurance payments, applying them to the correct accounts.
• Handle appeals and re‑submissions for denied or underpaid claims.
• Maintain detailed records of billing transactions, postings, and adjustments.
• Generate and analyse reports on billing, collections, and accounts receivable to optimise revenue.
• Stay updated on changes in insurance policies, coding requirements, and healthcare regulations.

Required profile

• Mid‑level experience with at least 24 months in medical billing or coding.
• Strong understanding of insurance eligibility verification and claim processing.
• Ability to communicate clearly with patients, providers, and insurance representatives.
• Attention to detail and ability to resolve billing issues promptly.

Required skills

• Medical coding
• Claims processing