Claims Officer (Nurse) Job at MetroHealth HMO

MetroHealth HMO is a leading Nigerian health insure-tech company that offers unparallel tech-driven comprehensive primary, secondary, and tertiary health insurance services across Nigeria.

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.

Requirements

• 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.

Method f Application
Interested and qualified candidates should send their CV to: aoseji@metrohealthhmo.com using the Job Position as the subject of the mail.