- Minimum Qualification :
- Experience Level : Entry level
- Experience Length : 2 years
Job Description/Requirements
Job Title: Medical Claims Officer
Number of Positions: 2
Work Locations: Suhum (Eastern Region) & Assin Fosu (Central Region)
About Elucid Social
At Elucid Social, we make human health benefit supply chains.
We provide an innovative health solution that enables companies to generate
high-quality data for sustainability and compliance reporting while improving the
health and living standards of farming households.
By translating healthcare actions into meaningful data, we help supply chains build
consumer trust, meet regulatory requirements, and support farming communities with
better access to healthcare.
Position Overview
We are seeking Medical Claims Officers to join our dynamic team and support the
Implementation of our health programs.
This role is responsible for the accurate processing and management of medical claims submitted by healthcare providers.
Ideal candidates will have prior experience in medical claims processing, especially within Ghana’s NHIS system, and a keen understanding of healthcare systems in Ghana.
Key Responsibilities
● Review, validate, and process medical claims submitted by healthcare
providers in accordance with organizational guidelines.
● Ensure compliance with operational procedures and NHIS policies during
claims assessment.
● Liaise with healthcare providers and beneficiaries to address discrepancies and
obtain clarifying information.
● Prepare regular reports on claims processing trends, discrepancies, and key
performance metrics.
● Collaborate with internal and external stakeholders to streamline and improve
claims management processes.
● Train and guide healthcare providers on proper claims submission protocols.
● Conduct site visits to partner healthcare facilities to assess, verify, and ensure
the accuracy and legitimacy of submitted claims.
Qualifications and Desired Competencies
● A minimum of a Diploma or Bachelor's degree in Accounting, Business
Administration, Health Management, Insurance, or a related field.
● At least 2 years of professional experience in medical claims processing, ideally
with the NHIS or private health insurers.
● Familiarity with healthcare systems and facilities in Ghana is highly desirable.
● Strong knowledge of the Ghana National Health Insurance Scheme (NHIS)
policies and claims protocols.
● Excellent analytical skills to assess medical documentation and claims.
● High attention to detail and ability to identify inconsistencies in claims.
● Effective communication and interpersonal skills for engaging with healthcare
providers, policyholders, and internal teams.
● Strong problem-solving skills and capacity to resolve claim disputes
professionally.
● Proficiency in claims processing software, Microsoft Office Suite, and relevant
databases.
Why Join Elucid Social?
● Work at the intersection of health, technology, and sustainability
● Make a measurable impact on farmer health and supply chain transparency
● Enjoy a competitive compensation package
● Join a passionate, mission-driven team working to improve lives across Africa
How to Apply
We’d love to hear from you!
? Please submit your CV and cover letter by April 25th, 2025 to wilhelmina.tetteh@elucid.de
Elucid Social is an equal opportunity employer, and we are committed to building a diverse and inclusive team.
Learn more about our work by visiting our Website (elucid.social) or LinkedIn page.
#Hiring #MedicalClaims #HealthcareJobs #GhanaJobs #Suhum #AssinFosu #ElucidSocial #ImpactWork #HealthInnovation
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