Medical Case Officers at Metrohealth HMO Limited (3 Openings)

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

We are recruiting to fill the position below:

Job Title: Medical Case Officer

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
2nd September, 2024.