Summary
Date Posted: Wednesday, November 01 2023, Base Salary: Not Disclosed

JOB DETAILS:
Job Summary
• A Health Insurance Support Officer will ensure patients are registered under NHIMA prior to being attended to by the consultant’s appointment/surgery. The incumbent shall ensure that all the patients pass through the insurance desk prior and after consultancy, surgeries and discharges. Process claims after consultation and seek pre-authorization prior to surgery.

Duties Main Duties/Responsibilities:
· Receive and process claims (manual and electronic) for payment.
· Seek Pre-authorization prior to surgery for all procedures in line with the NHIMA Benefits package.
· Resolve queries from NHIMA members in line with the hospital procedures
· Explain the benefits of the NHIS coverage and cost saving benefits to patients regularly.
· Liaise and engage medical personnel /Reception staff on picking the correct diagnosis/procedure for all claims covered in the Benefits Package.
· Download processed claims and invoice NHIMA via Xledger
· Capture approved Pre-authorizations as claims.
· Review submitted claims and pre-authorizations and follow up on rejected claims and Pre-authorizations leading to resubmission.
· Verify membership before claim capture and Pre-authorizations are submitted.

Job Requirements
Qualification And Experience
§ A diploma in Insurance/Marketing/ Sales/ Accounting or any related field or its equivalent.
§ Member of PIA/ZIM/ZICA (with full membership license)
§ 1-3 years relevant experience preferably someone who has worked in a Health Institution.
§ Skilled proficiency in computers and Electronic Medical Records

Knowledge, Skills & Abilities:
• Accuracy
Attention to detail
Team player

Competencies:
1. Communication Skills
2. Decision Making & Problem Solving – Able to take action in solving problems while exhibiting judgment and a realistic understanding of issues; able to use reason, even when dealing with emotional topics; review facts and weigh options.
3. Integrity – Ability to be tactful, maintain confidence, and foster an ethical work environment; prevent inappropriate behavior by coworkers; give proper credit to others; handle all situations honestly.
4. You must be a mature Christian

Work Environment:
• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position the employee must perform all duties in conformance to appropriate safety and security standards. The noise level in the work environment is usually low.

Physical Demands:
• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
• The employee must be able to regularly lift and/or move up to 0 pounds.
Specific vision abilities required by this position include close vision and ability to adjust focus.
• While performing the duties of this position, the employee is required to:
• Frequently sit, talk and hear
• Occasionally walk, reach with hands and arms, climb, balance, stoop, kneel, crouch and crawl.

Work Hours: 8

Experience in Months: 12

Level of Education: Postgraduate Degree

Job application procedure
• Please apply using the following link 
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