Thu. Oct 6th, 2022

MetroHealth HMO is a Nigerian leading health management organization with an aim to render unparalleled technology-based and comprehensive primary, secondary, and tertiary health care services across the country. MetroHealth was registered by the regulatory authority, the National Health Insurance Scheme (NHIS) to operate as a national HMO in 2013.

With over 650 partner hospitals, we are committed to rendering world-class preventive and curative health care services to our clients in the easiest and stress-free method. We understand that every client is unique and deserves flexible, specialized solutions; therefore we embrace an individualized approach towards taking excellent care of our clients.

We are big on maximizing the blessings of technology to render 21st century-based health services making sure our clients are in the best state of health.

We are recruiting to fill the position below:

 

 

Job Title: Claims Supervisor

Location: Lagos
Employment Type: Full-time

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Job Responsibilities

  • Coordinate the management of all Claims processes from submission, initial review, sorting and tracking, pre-processing, adjudication, review, scheduling for payment and then reconciliation and sign off on paid claims.
  • Regular reports on claims status, receipt, processed and payment.
  • Monitoring and evaluation of utilization patterns by
  • Analysis of preauthorization reports to identify regional and provider specific trends and propose process changes and policies for effective utilization management
  • Analysis of claims reports to identify regional and provider specific trends and propose process changes and policies for effective utilization management
  • Regular reports on claims status, trends and utilization patterns.
  • Ensure Accurate processing of all claims following proper enrolee verification, enrolee eligibility, PA confirmation, and according to contracted fee schedule with provider.
  • Ensure timely processing of claims and appeals on FIFO bases to ensure payment within 30 days of receipt of claims.
  • Ensure proper filing and maintenance of claims documents and make sure the information is readily available.
  • Conducts a review of processed claims for errors and ensure accuracy of processed claims and preparation of claim schedules for payment
  • Responsible for the supervision of the staff in claims unit including training and team building.
  • Any other activity as assigned by management
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Requirements

  • Minimum B.Sc. / HND in any discipline
  • Minimum of five (5) years of cognate experience on same role and in the HMO industry

 

 

How to Apply
Interested and qualified candidates should send their CV tometrovacancies@gmail.com using the Job title as the subject of the mail.

Note

  • Experience in HMO industry is compulsory
  • Only shortlisted candidates will be contacted

 

 

Note:

  • we are an equal opportunity employer and is committed to building a diverse workforce. While all applications will be acknowledged.
    • We reserves the right to select one or more candidates from this vacancy announcement
    • We may also retain applications and consider candidates applying to this post for other similar positions at the same grade level and with similar job description, experience and educational requirements
    • Qualified female candidates are strongly encouraged to apply
    • Scam Warning:
    We do not charge any application, processing, training, interviewing, testing or other fee in connection with the application or recruitment process. Should you receive a solicitation for the payment of a fee, please disregard it.
    • Furthermore, please note that emblems, logos, names and addresses are easily copied and reproduced.
    • Therefore, you are advised to apply particular care when submitting personal information on the web
    • Only shortlisted candidates will be invited for interview or the next stage of the recruitment process.
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Application Deadline  8th January, 2021.

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