Posted on: Wed 14-02-2024

MetroHealth HMO is a leading Nigerian health insure-tech company that offers unparalleled tech-driven comprehensive primary, secondary, and tertiary health insurance services across the country.

We are recruiting to fill the position below:

Job Title: Nurse Auditor

Locations: Rivers

Employment Type: Full-time

Job Description

• Review daily in-process reports for newly assigned claims
• Request documentation from the Office Assistant needed to complete the clinical review of assigned claims
• Review coding of professional bills utilizing requested procedural notes
• Review itemized bills and medical records for medical appropriateness and inconsistencies by performing a line-by-line clinical review of the claim
• Research unfamiliar procedures as needed via web
• Contact the provider's representative to resolve billing issues
• Contact the provider's representative to negotiate the claim
• Confirm repricing information with the provider
• Provide status of outstanding claims upon request
• Prepare management reports of findings for submission to clients

Requirements

• The ideal candidate must be a Registered Nurse
• Should possess a minimum of 2 years experience (HMO experience will be an added advantage).

How to Apply

Interested and qualified candidates should send their CVs to: [email protected] using the Job Title as the subject of the mail.

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