CLAIMS OFFICER / CARE COORDINATOR at Box and Cedar

Job Description:

• Analysing and processing of NHIS fee-for-service claims
• Checking enrollee status and approval
• Vetting bills according to NHIS tariff
• Noting discrepancies on the bills and writing or return of claims to affected provider
• Posting of issued cheques for paid claims
• Attachment of bill analysis to paid claims
• Filing of all paid claims
• Computerized processing of NHIS data.
• Assisting in processing NHIS capitation
• NHIS registration of enrollees
• Visitation of NHIS providers / parastatals
• Documenting / imputing of NHIS primary providers bank details
• Giving of approvals to secondary providers for NHIS enrollees
• Payment of NHIS providers capitation to banks
• Notification through correspondences and calls to NHIS providers on payment of capitation to their bank account
• Filing acknowledgement copies/receipts of capitation
• Attending to calls on NHIS enrollee providers
• Attending to NHIS enrollee complaints on omission of names or changes in ID cards (Registration)
• Assisting in enrollee enlightenment on the operation of NHIS
• Other duties as assigned

Minimum Qualification:

• * Nurses with BSc, RN and RM with post qualification experience 1 of which in a HMO
• * Fresh Graduate's can also apply.

Knowledge & Skills:

 * Possesses good verbal and written skills
 * Communication Skills
 * Problem Solving Skills
 * Listening Skills
 * Attention to details
 * Team Work
 * Resilience
 * Adaptability
 * Initiative

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Job Description:

• Analysing and processing of NHIS fee-for-service claims
• Checking enrollee status and approval
• Vetting bills according to NHIS tariff
• Noting discrepancies on the bills and writing or return of claims to affected provider
• Posting of issued cheques for paid claims
• Attachment of bill analysis to paid claims
• Filing of all paid claims
• Computerized processing of NHIS data.
• Assisting in processing NHIS capitation
• NHIS registration of enrollees
• Visitation of NHIS providers / parastatals
• Documenting / imputing of NHIS primary providers bank details
• Giving of approvals to secondary providers for NHIS enrollees
• Payment of NHIS providers capitation to banks
• Notification through correspondences and calls to NHIS providers on payment of capitation to their bank account
• Filing acknowledgement copies/receipts of capitation
• Attending to calls on NHIS enrollee providers
• Attending to NHIS enrollee complaints on omission of names or changes in ID cards (Registration)
• Assisting in enrollee enlightenment on the operation of NHIS
• Other duties as assigned

Minimum Qualification:

• * Nurses with BSc, RN and RM with post qualification experience 1 of which in a HMO
• * Fresh Graduate's can also apply.

Knowledge & Skills:

 * Possesses good verbal and written skills
 * Communication Skills
 * Problem Solving Skills
 * Listening Skills
 * Attention to details
 * Team Work
 * Resilience
 * Adaptability
 * Initiative