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CLAIMS MANAGER at NEW CRYSTAL HOSPITAL
Job Overview
New Crystal Hospital is seeking an experienced and detail-oriented Claims Manager to oversee the processing and management of medical insurance claims across its branches. The successful candidate will be responsible for ensuring the accurate and timely submission of National Health Insurance Scheme (NHIS) and private health insurance claims, monitoring claim reimbursements, resolving discrepancies, and maintaining compliance with insurance policies and regulatory requirements. The role also involves supervising the claims team, improving claims processing efficiency, reducing claim rejections, and collaborating with clinical departments and insurance providers to ensure smooth operations. The ideal candidate should possess strong leadership, analytical, communication, and problem-solving skills, with at least three years of experience in medical claims management.
Key Responsibilities
- Oversee daily processing of NHIS and private insurance claims across all branches.
- Vet claims for accuracy, completeness and compliance.
- Monitor rejected claims and implement corrective measures.
- Lead, train and supervise the claims team.
- Ensure timely submission and follow-up of claims.
- Reconcile claims submitted against reimbursements received.
- Liaise with clinical departments and insurance providers.
Requirements & Qualifications
- Bachelor's Degree in Business Administration, Finance, or a related field.
- Minimum of 3 years' experience in medical claims management.
- Experience with NHIS and private health insurance.
- Strong leadership, analytical and communication skills.