Posted on: Fri 13-11-2020

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

Location: Abuja

Background

• 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.

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.

Qualifications

Education:

• 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;

Experience:

• Minimum 3 years of continuous Claims Management experience;
• Experience in the usage of computers and other relevant software packages is desirable.

Language Requirements:

• Fluency in oral and written English is a requirement.

Competencies:

Professionalism:

• Knowledge and experience in Claims Management.

Communication:

• Ability to write in a clear and concise manner and to communicate effectively orally.

Teamwork:

• 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.

Technological Awareness:

• Proficiency in relevant medical software packages.

Commitment to Continuous Learning:

• Initiative and willingness to keep abreast of new skills in the field.

Application Closing Date

26th November, 2020.

Method of Application

Interested and qualified candidates should send their Application and CV to: [email protected] 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.

---

---