- Ensure capturing of all incurred claims
- Vetting of claims on structure OPD and Inpatient benefit filters
- Adjudicate claims administratively and medically
- Reconciling claims reported with HSPs
- Auditing claims with the priority of identifying fraud
- Advice finance on processed claims for payment
- Carry out quarterly clinical audits at the provider end
- Keep an up to date record on all provider and member claims
- Ensure proper conduct and high performance level of claim officers
- Coordinate activities of all claims officers to ensure effective and timely payment of claims
- Produce monthly savings reports on rejections and cancelled fraudulent claims
- Preparing weekly and monthly reports on all activities of the claims department.
- Carrying out any other duties as directed by the company.
Qualification and Requirements
- A minimum of a Degree in Nursing
- At least one year experience in a similar role
Interested candidates should send CVS to:email@example.com
How to Apply?
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