Health Service / Quality Assurance Manager is needed at Markfema Nigeria Limited

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Web Quality Assurance Partner is needed at United Bank for Africa
Marketing Manager is needed at Tetra Pak

Markfema Nigeria Limited’s job vacancy, Career and Recruitment

Job title : Health Service / Quality Assurance Manager jobs in Abuja

Job Location : Abuja

Deadline : February 14, 2022

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Reporting to: MD / CEO

The Candidate

  • Shall be ready to work hard and push the limits in ensuring claims vetting and fluent management process.
  • Shall oversee thevetting of all claims submitted by our Providers to ensure they are error and fraud-free
  • They will manage claims payment and be involved in the resolution of medical cases requiring special attention.

Key Responsibilities

  • Examine Healthcare Providers‰Ûª Claims using the Tariff agreement to determine authenticity and payment.
  • Decline fraudulent Healthcare Providers‰Ûª Claims and state causative reasons.
  • Forward approved Claims to Team Lead for review and final approval.
  • Investigate complicated Claims and escalate to the Team lead, if necessary.
  • Carry out a physical inspection at the assigned provider‰Ûªs office using the checklist.
  • Investigate complicated claims by checking the case folder and speaking to the Enrollee and the doctor.
  • Update Providers‰Ûª dashboard, and implement resolutions.

Minimum Qualifications

  • Minimum of a Bachelor of Medicine and Bachelor of Surgery (MBBS) with a post-graduate qualifications
  • 10 years of work experience.
  • Previous relevant work experience in a similar role is highly desired
  • Excellent Numeracy, Analytical and Problem-solving skills.
  • Strong ability to make judgments on medical/ surgical cases in relation to benefits listed on enrollee‰Ûªs benefits.
  • Ability to make a professional judgment on coverage and non-coverage of care requests per time, based on the enrollee‰Ûªs benefits table.
  • Candidate must have strong computer skills.

*Medical / Healthcare jobs in Nigeria

*Medical / Healthcare jobs in Abuja

*Health Service / Quality Assurance Manager in Abuja

How to Apply for this Offer

Interested and Qualified Candidates should Click here to Apply online

Web Quality Assurance Partner is needed at United Bank for Africa
Marketing Manager is needed at Tetra Pak

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