Claims Supervisor at MetroHealth HMO Limited

MetroHealth HMO Limited is a leading Nigerian health insure-tech company that offers unparallel tech-driven comprehensive primary, secondary, and tertiary health insurance services across the country. MetroHealth HMO uses a robust system of data analysis to determine pricing for health insurance services to its valued enrollees.

We are recruiting to fill the position below:

Job Title: Claims Supervisor

Location: Lagos Island, Lagos
Employment Type: Full-time

Role Description

• The Medical Claims Specialist would be responsible for managing claims and approvals processes, and the scope of work includes vetting health insurance claims and approval from service providers, reconciling payments and negotiating and uploading claim tariffs.

Key Responsibilities

• Examine and approve or reject healthcare providers' claims to meet set targets.
• Investigate claims for fraud, waste, and abuse.
• Promptly resolve escalated approval requests for care.
• Negotiate tariffs and update the providers' dashboard and execute other elements of tariff management.
• Collaborate with the technology team to improve the processes claims, tariff and approvals management system.
• Collaborate with customer success and provider relations teams to ensure customer satisfaction goals.

Requirements

• Minimum of a first degree in nursing or pharmacy or a related discipline.
• Previous experience as a claims officer is a major requirement.
• Excellent numeracy, analytical and problem-solving skills.
• A high-level of responsiveness is essential .
• Strong medical and clinical knowledge and experience.
• Excellent interpersonal and communication skills.

 Salary
N250,000 - N300,000 Monthly.

Application Closing Date
7th April, 2025.

How to Apply
Interested and qualified candidates should send their CVs to: aoseji@metrohealthhmo.com using the job title as the subject of the mail.