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 or possess B.Sc. Nursing with valid license.
Candidate must have a minimum of Credit or Second Class Upper Division and additional medical qualification will be an added advantage
Candidate must have minimum of 1 year clinical experience and experience in similar role in a Health Maintenance Organization (HMO) will be an added advantage
Candidate must have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes, and Scheme Rules
Excellent organizational, communication (verbal and written), listening skills and attention to detail.
Candidate must be very proficient in Microsoft office packages
Other requirements:
Good organizational and planning capabilities
Innovative and quick thinking capabilities
Innovativeness
Adaptive
Decision Making skills
Integrity
Ability to work under pressure
Adaptive, expertise, Result-Oriented, Relationship Skill
Working with people
Must be a good collaborator/Team player
Apply via :
totalhealthtrustlimited.has-jobs.com
