Immediate Start
New
3 days ago
Claims Officer
Ashmed Integrated Health Services Limited
Health & Safety
Healthcare
NGN
250,000 - 400,000
Easy Apply
Job Summary
The Claims Officer is responsible for the accurate review, verification, and processing of healthcare claims submitted by providers in line with NHIA guidelines and company policies. The role involves working closely with the medical review and finance teams to ensure only valid and approved claims are paid, while also detecting errors, inconsisten
- Minimum Qualification : HND
- Experience Level : Mid level
- Experience Length : 4 years
Job Description/Requirements
Responsibilities:
- Receive, sort, and review all incoming claims from providers
- Verify supporting documents, code accuracy, and compliance with NHIA standards
- Identify errors, inconsistencies, and possible abuse or fraud
- Work closely with the medical review team for clinical validation
- Process approved claims within agreed timelines
- Maintain accurate records of processed, pending, and queried claims
- Follow up with providers on incomplete or unclear submissions
- Prepare weekly and monthly reports for management
- Support reconciliation of provider accounts when required
- Ensure confidentiality and compliance with internal policies
Requirements:
- Minimum of HND or BSc in Health Information Management, Insurance, Health Administration, Accounting, Biological Sciences, or any related field
- Experience in claims processing within an HMO or hospital is required
- Strong attention to detail and good analytical ability
- Good understanding of medical terminology
- Solid communication skills and confidence in engaging providers
- Proficiency in Excel and basic data analysis
- Ability to work under pressure and meet timelines
What We Offer
- A supportive environment with opportunities to learn health insurance operations
- Growth and career development within the organisation
- Competitive remuneration
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