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

The job holder is responsible for reviewing and vetting bills/claims received from secondary and tertiary health care providers before payment. He/she is also responsible for implementing its risk management policy, operational procedures, and guidelines.

• Review and vet bills/claims received from secondary and tertiary health care providers and ensure that they are following NHIS agreed on tariff or fee schedule. 
• Ensure that all claims are received within 14 days from the end of each month.
• Ensure prompt processing of claims within 14 days from receipt from the Facilities.
• Ensure availability and timely delivery of health care services at the right time and place by the Facilities.
• Maintain accurate and up to date database/records on fee claims submitted by the Facilities.
• Establish strong customer/member focus that will ensure efficient service delivery and customer satisfaction.
• Ensure that all activities of Facilities are conducted in conformity with established industry standards, practices, and NHIS guidelines.
• And any other responsibility that may be assigned to you