A reputable dynamic and leading NHIS Accredited National Health Maintenance Organization is looking to recruit suitable candidates to fill the position below:
Job Title: Head, Claims Management Unit
- The Head of Claims Unit will oversee the handling of all claims in line with the approved NHIS Drug and Service tariffs for payment to secondary/tertiary healthcare providers that render services on referrals from other accredited healthcare providers.
- These functions are performed under the immediate supervision of the Head, Medical & Quality Assurance Department and would also be required to serve in acting capacity when the Head of Medical Department is not available.
- Registered Professional Nurse and first-level degree from an accredited Baccalaureate Nursing Programme (University) or equivalent.
- National registration and licensing are required.
- Recognized additional training in primary health care and midwifery is desirable;
- Minimum 3 years of continuous Claims Management experience;
- Experience in the usage of computers and other relevant software packages is desirable.
- Fluency in oral and written English is a requirement.
- Knowledge and experience in Claims Management.
- Ability to write in a clear and concise manner and to communicate effectively orally.
- Good interpersonal skills; ability to work in a multi-cultural, multi-ethnic environment with sensitivity and respect for diversity.
- Establishes, build and sustain effective relationships within the work unit.
Planning and Organizing:
- Develops clear goals that are consistent with agreed strategies;
- Ability to establish priorities and to plan and co-ordinate own work plan;
- Allocates appropriate amount of time and resources for completing work;
- Foresees risks and allows for contingencies when planning;
- Monitors and adjusts plans and actions as necessary; uses time efficiently.
- Organizes and prioritizes work schedule to meet deadlines.
- Proficiency in relevant medical software packages.
Commitment to Continuous Learning:
- Initiative and willingness to keep abreast of new skills in the field.
Duties And Responsibilities
- Coordinate and supervise the activities of the Unit to ensure optimal performance;
- Coordinate and handle the collation, entry and analysis/reporting of encounter returns from hospitals
- Analyze data for bill presentation based on requirements and review claims for quality and elimination of fraud
- Maintains supplies inventory for our train operations by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies; verifying receipt of supplies; using equipment and supplies as needed to accomplish results
- Maintains a cooperative relationship among team members by communicating information, responding to requests, building rapport and participating in team problem-solving methods
- Coordinate and oversee maintaining of records as it relates to all the activities in the Unit.
- Stays up to date on regulations, and implements changes regarding claims and billing requirements
- Ensures quality health care delivery to enrollees by continuous monitoring and evaluation of healthcare facilities.
- All other duties that might be assigned by reason of the position.
Deadline: 26th November, 2020.
Method of Application
Interested and qualified candidates should send their Application and CV to: firstname.lastname@example.org using the “Job Title” as the subject of the email.
Note: Only shortlisted candidates will be contacted and advance to the next stage of the selection process.