The key deliverables for the role are;

• Attending to providers, specialists and customer queries by determining their requirements, answering to these inquiries, resolving problems, and ensuring good service as a friendly cost.
• Adjudicating inpatient and outpatient medical claims while verifying the accuracy of information provided.
• Managing healthcare costs by ensuring that care is appropriate, cost-effective, and aligned with policy coverage.

Qualifications;

• Bachelor’s degree or a Diploma in Nursing, Clinical Medicine, Healthcare Management.
• Strong background in medical claims assessment will be a plus including knowledge of medical terminology, coding (ICD-10, CPT, HCPCS), and treatment procedures.
• At least 1 to 3 years’ of experience in health insurance claims processing, adjudication, or claims management.