2 weeks ago
Job title : Claims Officer (Nurse)
Job Location : Lagos
Deadline : October 30, 2024
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JOB DESCRIPTION
- Process and adjudicate health insurance claims in a timely and accurate manner
- Verify coverage and determine eligibility for members
- Process payments to providers
- Resolve member complaints and investigate potential fraud
- Maintain accurate and uptodate records of all claims
- Work with other departments to ensure that claims are processed and adjudicated in accordance with company policies and procedures
- Stay uptodate on the latest changes to healthcare laws and regulations
- Provide excellent customer service to members and providers
- Review payments to seller partner pharmacies, telemedicine and laboratories.
- Adhere to claims processing procedures keeping accurate records of HMO orders, supplies by partner providers, confirm receipts in writing by HMO enrollees and proper submission of claims to HMOs.
- Keep proper records of outstanding claims at the providers and HMOs and ensure proper reconciliation
- Ensure ontime payment by the HMOs
REQUIREMENTS
- Must be a Registered Nurse
- 1-3 years of experience in claims processing or a related field
- knowledge of health insurance plans and benefits
- Excellent analytical and problemsolving skills
- Ability to work independently and as part of a team
How to Apply for this Offer
Interested and qualified candidates should forward their CV to: [email protected] using the position as subject of email.
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