{"id":3598087,"url":"https://alion.io/job/acs-provider-reconciliation-officer","title":"Provider Reconciliation Officer","company":{"id":4493953,"name":"ACS","domain":"acs.co.ke","url":"https://alion.io/company/acs-4","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":null,"truth_index":null},"role":"Finance","role_family":"Finance","seniority":"junior","employment_type":null,"work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Nairobi, Kenya"],"countries":["KE"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":null,"experience_years_min":2,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Excel","optional":false}],"status":"live","first_seen_at":"2026-11-02T04:34:00Z","employer_posted_date":null,"last_verified_at":"2026-11-02T04:34:00Z","board_verified":false,"closed_at":null,"days_open":12,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":12},"description":"Finance Jobs, ACS Jobs. Responsible for reconciling provider accounts, verifying invoices and payments, investigating billing discrepancies, maintaining accurate financial records, and preparing reconciliation reports. Requires a diploma or degree in Accounting, Finance, or a related field. This is a full-time, on-site position based in Nairobi.\n\nRole Purpose\n\nThe 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.\n\nWithin 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.\n\nKey Responsibilities\n\nProvider Account Reconciliation\n\nPerform regular reconciliation of provider statements against adjudicated claims and payment records.\n\nVerify the accuracy of provider invoices, statements, remittances, and account balances.\n\nMatch approved claims against payments made to healthcare providers.\n\nReview provider accounts to identify discrepancies, overpayments, underpayments, duplicate payments, and unallocated transactions.\n\nInvestigate and resolve unidentified or unmatched transactions.\n\nMaintain accurate reconciliation schedules and supporting documentation.\n\nClaims and Payment Verification\n\nValidate claims included in provider invoices prior to payment processing.\n\nReconcile approved claims against contractual payment schedules and approved tariffs.\n\nVerify deductions, recoveries, reversals, and adjustments applied to provider accounts.\n\nReview rejected and partially settled claims and ensure proper documentation.\n\nEnsure all payment records are accurately reflected in reconciliation reports.\n\nCollaborate with Claims and Finance teams to address payment variances.\n\nProvider Query and Dispute Resolution\n\nRespond promptly to provider enquiries relating to invoices, payments, deductions, recoveries, and account balances.\n\nInvestigate provider disputes and reconciliation exceptions.\n\nLiaise with relevant internal departments to obtain supporting documentation and resolutions.\n\nMaintain records of provider disputes and resolution actions.\n\nFollow up on open reconciliation issues until closure.\n\nEnsure timely communication with providers regarding outstanding matters.\n\nFinancial Control and Risk Management\n\nIdentify financial discrepancies and escalate material risks appropriately.\n\nMonitor ageing balances and unresolved reconciliation items.\n\nSupport recovery of overpayments and identification of duplicate claims.\n\nEnsure compliance with reconciliation controls and financial procedures.\n\nAssist in prevention and detection of billing irregularities and fraudulent claims.\n\nContribute to initiatives aimed at improving payment accuracy and financial controls.\n\nProvider Relationship Management\n\nMaintain professional working relationships with healthcare providers.\n\nParticipate in provider engagement meetings where reconciliation issues are discussed.\n\nSupport initiatives aimed at improving provider satisfaction and payment transparency.\n\nPromote effective communication between providers and internal stakeholders.\n\nFacilitate resolution of provider concerns through collaborative engagement.\n\nReporting and Documentation\n\nPrepare daily, weekly, and monthly reconciliation reports.\n\nGenerate exception reports highlighting unresolved discrepancies.\n\nMaintain comprehensive reconciliation records and supporting documentation.\n\nMonitor reconciliation trends and recurring issues.\n\nProvide reconciliation updates to management as required.\n\nSupport month-end and year-end financial reporting processes.\n\nProcess Improvement\n\nIdentify gaps and inefficiencies within reconciliation processes.\n\nRecommend improvements to enhance reconciliation accuracy and efficiency.\n\nParticipate in process improvement projects and system enhancement initiatives.\n\nSupport implementation of new controls, procedures, and reconciliation tools.\n\nContribute to continuous improvement of provider settlement processes.\n\nCompliance and Governance\n\nEnsure compliance with organizational policies and procedures.\n\nAdhere to contractual agreements with healthcare providers.\n\nMaintain confidentiality of provider, client, and member information.\n\nSupport audit exercises by providing reconciliation documentation and reports.\n\nEnsure compliance with regulatory and industry requirements.\n\nPromote adherence to ethical and professional standards.\n\nKey Performance Indicators\n\nProvider Reconciliation Accuracy\n\nTimeliness of Reconciliation Completion\n\nProvider Query Resolution\n\nOutstanding Reconciliation Item Resolution\n\nClaims and Payment Matching Accuracy\n\nProvider Dispute Resolution\n\nCompliance with Reconciliation Procedures\n\nAccuracy and Timeliness of Reconciliation Reports\n\nQualifications\n\nBachelor’s Degree in Accounting, Finance, Business Administration, Economics, Insurance, Health Records, Healthcare Management, or a related field.\n\nProficiency in Microsoft Excel and reconciliation systems.\n\nExperience\n\nMinimum of 2 years’ experience in healthcare finance, claims management, provider reconciliation, medical insurance, managed care, or a related field.\n\nExperience working within a TPA, health insurer, managed care organization, or healthcare administration environment is preferred.\n\nHow to Apply\n\nClick here to 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