Nurse Auditors at Metrohealth HMO Limited - 3 Openings

MetroHealth HMO is a leading Nigerian health insure-tech company that offers unparallel tech-driven comprehensive primary, secondary, and tertiary health insurance services across the country.

We are recruiting to fill the position below:

Job Title: Nurse Auditor

Locations: Abuja (FCT), Lagos, and Rivers
Employment Type: Full-time

Job Description

• Review daily in-process report for new assigned claims
• Request documentation from Office Assistant needed to complete clinical review of assigned claims
• Review coding of professional bills utilizing requested procedural notes
• Review itemized bill and medical records for medical appropriateness and inconsistencies by performing a line by line clinical review of claim
• Research unfamiliar procedures as needed via web
• Contact provider's representative to resolve billing issues
• Contact provider's representative to negotiate claim
• Confirm repricing information with provider
• Provide status of outstanding claims upon request
• Prepare management reports of findings for submission to clients

Requirements

• The ideal candidate must be a Registered Nurse
• Should posses minium of 2 years experience (HMO experience will be an added advantage).

Application Closing Date
28th February, 2024.