Vetting Officer – HMO at Zuma Health Trust Limited

Zuma Health Trust Limited is an indigenous Health Maintenance Organization (HMO) established in 1997. It is registered with the Corporate Affairs Commission (CAC) and accreditation by the National Health Insurance Authority(NHIA) as a National Health Maintenance Organization to provide health insurance services for all Nigerians.

The company provides health insurance cover for all classes of Nigerians: individuals, families, private organizations, corporate bodies, government and public employees as well as all categories of persons

We are recruiting to fill the position below:

Job Title: Vetting Officer – HMO

Location: Jabi, Abuja (FCT)
Employment Type: Full-time

Job Description

• Examine bills and claims from Health Care Providers (HCPs) and enrollees using agreed Tariff to ensure authenticity.
• Investigate suspicious claims through Enrollee contact, case folder checks and otherapproved protocols
• Escalate complicared fraudulent claims to QA Team lead.
• Forward approved Claims to Team Lead for review and final approval.
• Generate or prompt payment advice to HCPs for FFS payments made .
• Undertake physical inspection and routine visitat providers’ facilities using service checklist.
• Participate in the resolution of medical claims cases requiring rigorous negotiations
• Undertake reconciliation of accounts with HCPs on claims

Requirements

• First Degree or its equivalent in Nursing or a related field
• Must have a minimum of 2 years vetting experience with a Health Maintenance Organization (HMO)
• Degree or its equivalent qualification in nursing, midwifery or any other relevant field
• Certification in professional membership in related bodies
• Good knowledge of excel, word and data analytics
• At least 3years post NYSC experience
• Must have minimum of 2 years vettingexperience with a Health Maintenance Organization
• Up to date Nursing and or midwifery council of Nigeria certification
• Attendance of relevant course workshop and seminars I related fields.

Remuneration
N140,000 – N170,000 Monthly (based on experience).

Deadline: 20th September, 2022.

Method of Application
Interested and qualified candidates should send their CV only to: hrzuma028@gmail.com using the Job Title as the subject of the mail.

Note: Only shortlistedcandidates will be contacted.