Total Health Trust Limited - Our organization is a leading and largest health maintenance organization (“HMO”) in Nigeria with over 270,000 members and over 270 private corporations representing some of the country’s top local and international multinationals, as well as public sector institutions under our management. We were the first HMO to be registered in Nigeria and 17 years later, we are still number one in the market. We are one of the very few HMOs that can boast the financial and technical backing of a world class company - Liberty Health (a member of the Liberty Group). The organization further prides itself with its rich culture of Respect, Compassion, Pride and Expertise.
POSITION : Claims Assessor
Job Description
To vet all claims pertaining to either the managed care or Blue product to ensure that the daily targets are achieved
To capture all claims pertaining to either the managed care or Blue products to ensure that the daily targets are achieved
Send out cheques to providers within the agreed SLA
To ensure all Claims correspondence to providers or members are sent out timeously
To adhere to and live the organisational values.
Requirements
Candidate must be a registered nurse, midwife and possess B.Sc. Nursing
Additional medical qualification will be an added advantage
Candidate must have minimum of 4 years post-nursing qualification experience including 2 years in similar role in a Health Maintenance Organization (HMO).
Candidate must have Clinical experience
Candidate must have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes, Claims Processes and Procedures and Scheme Rules.
Excellent organizational, communication (verbal and written) skills and attention to detail.
Other Requirements:
Good organizational and planning capabilities
Innovative and quick thinking capabilities
Innovativeness
Adaptive
Decision Making skills
Integrity
Negotiation Skill
Adaptive, expertise, Result-Oriented, Relationship Skill
Working with people
Strategic
Must be a good collaborator/Team player.
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