Nigeria Job Openings
MetroHealth HMO Limited
Claims Officer (Nurse)
Lagos
FULL TIME
October 9, 2024
We are recruiting to fill the position below:
Job Position: Claims Officer (Nurse)
Job Location: Lagos
Employment Type: Full Time
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 up-to-date records of all claims
- Work with other departments to ensure that claims are processed and adjudicated in accordance with company policies and procedures
- Stay up-to-date on the latest changes to healthcare laws and regulations
- Provide excellent customer service to members and providers
- 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 on-time payment by the HMOs.
- Must be a Registered Nurse
- 1-3 years of experience in claims processing or a related field.
- Strong knowledge of health insurance plans and benefits
- Excellent analytical and problem-solving skills
- Ability to work independently and as part of a team.
Interested and qualified candidates should send their CV to: aoseji@metrohealthhmo.com using the Job Position as the subject of the mail.
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