Claims Manager at LEAD Enterprise Support Company Limited

LEAD Enterprise Support Company Limited is a foremost Human Resources Solutions organization with many years of cumulative management experience and expertise. We are prolific in Outsourcing, Recruitment, Head hunting and HR Advisory. We are a multi-sectorial servicing company with landmark service deliverables to our clients in varied industries.

We are recruiting to fill the position below:

Job Title: Claims Manager

Location: Lagos
Employment Type: Full-time

Responsibilities

• Design and implement various policies and procedures for claims.
• Provide services to all business requirements and ensure optimal handling of all claims and investigate all issues and provide training for all business units.
• Evaluate all new claims and administer all data integrity data and manage communication to safety department and monitor all claims and ensure timely closure.
• Evaluate all business units’ associate claims.
• Provide training to juniors to manage all outstanding claims and design an efficient duty program and coordinate with HR team to facilitate same.
• Perform regular quarterly audits on all local TPA offices.
• Monitor effectiveness of all programs and provide support to all open claim file reviews and manage all payment cycle to ensure compliance to all contract requirements.
• Design and maintain panel of investigators to use all TPA and prepare reports for monthly chargeback for all business units.
• Analyze all claims to ensure optimal quality and prepare reports for various business units and monitor all chargeback expenses and provide report to all clients and management.
• Perform investigation on all reserve increases and perform regular surveillance of all claim issues and maintain efficient location code listing for TPAs.
• Schedule all internal and external audits on all claims issues and supervise processing of all billing issues.
• Oversee all electronic claims processes and evaluate all self-insurance applications and prepare claims reports and evaluate all actuarial.
• Analyze all claims and identify all risks and ensure processing of all claims as per company policy.
• Forecast all staffing requirements and identify and resolve all issues effectively.

Requirements

• M.Sc in a Medical field.
• Minimum of 5 years experience in HMO and/or health related organization.
• HSE certified or any other health related field is applicable.

Application Closing Date
20th January, 2023.

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