International Health Management Services Claims Executive Jobs in Nigeria

International Health Management Services Claims Executive Jobs in Nigeria




Job Description

  • Receives and registers claims

  • Input vetted claims and prepares them for approval

  • Forward approved Claims to Team Lead for review and final approval

  • Receives and registers encounter data

  • Assisting the claims manager in preparing payment analysis for claims on the NHIS and private scheme

  • Respond to queries and concerns relating to the claims department

  • Decline fraudulent Healthcare Providers’ Claims, and state causative reasons

  • Escalate fraudulent claims to the Head of the Department

  • Investigate complicated Claims by speaking to Enrollees and providers

  • Investigate complicated Claims and escalate to the Team lead, if necessary.

    Qualifications and Skills

  • Must be a registered Nurse / Midwifery

  • Minimum of 2 years experience as a Health Insurance Claims Assessor

  • HMO Experience in a similar role is an added advantage

  • Excellent numeracy, analytical and problem-solving skills

  • Strong ability to make a judgment on medical/surgical cases in relation to enrollee’s benefits

  • Ability to make a professional judgment on coverage and non-coverage of care requests per time

  • Excellent interpersonal and communication skills




    How to Apply

    Interested and qualified candidates should send their Resume to: ihmsresponses@gmail.com using the Job Title as the subject of the email.

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