Medical and Quality Assurance Officer at Ultimate Health Management Services Limited

Responsibilities

• Capture and vet bills sent in from medical facilities.
• Issuance and confirmation of approval codes when necessary.
• Handle the collation, entry, and analysis/reporting of encounter returns from hospitals
• Analyse data for bill presentation based on requirements and review claims for quality and elimination of fraud.
• Build rapport and participate in team problem-solving methods.
• Maintain proper and accurate records as it relates to all the activities in the Unit.
• Proffer on the spot solution to enrollees’ challenges.
• Stays up to date on regulations, and implements changes regarding claims and billing requirements.
• Ensures quality healthcare delivery to enrolees by continuous monitoring and evaluation of healthcare facilities.

Skills & Requirements
Education:

• Registered Professional Nurse and a 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 of 2 years of continuous experience in a similar position;
• Experience in the usage of computers and other relevant software packages is desirable