Claims/Quality Assurance Officer at Songhai Health Trust Limited - HMO

About the Role

The Claims and Quality Assurance Officer is responsible for reviewing and vetting bills and claims received from secondary and tertiary health care providers before payment. This role involves implementing risk management policies, operational procedures, and guidelines to ensure compliance and service quality.

Key Responsibilities

• Review and vet bills and claims received from secondary and tertiary health care providers to ensure compliance with NHIS agreed tariffs and fee schedules
• Ensure all claims are received within 14 days from the end of each month
• Process claims promptly within 14 days of receipt from health facilities
• Monitor and ensure availability and timely delivery of health care services at appropriate locations by health facilities
• Maintain accurate and up-to-date database and records of all fee claims submitted by facilities
• Establish and maintain strong customer and member focus to ensure efficient service delivery and customer satisfaction
• Ensure all facility activities are conducted in conformity with established industry standards, practices, and NHIS guidelines
• Perform other responsibilities as assigned

Location

Lagos, Nigeria