Claims Officer at CENTURY MEDICAID SERVICES LIMITED (HMO)

Job Description:

Latest job information from CENTURY MEDICAID SERVICES LIMITED (HMO) for the position of Claims Officer. If the Claims Officer vacancy in Port Harcourt matches your qualifications, please submit your latest application or CV directly through the updated Jobkos job portal.

Please note that applying for a job may not always be easy, as new candidates must meet certain qualifications and requirements set by the company. We hope the career opportunity at CENTURY MEDICAID SERVICES LIMITED (HMO) for the position of Claims Officer below matches your qualifications.

Role Overview:

The Call Center Nurse serves as the clinical liaison between the HMO, healthcare providers, and enrollees. The role involves monitoring incoming requests from providers, answering calls, reviewing medical needs, and giving clinical authorizations in line with company policies and medical guidelines.

Key Responsibilities:

• Receive and triage calls from providers and enrollees.
• Monitor and process medical requests submitted by providers.
• Assess requests against clinical protocols and benefit packages before granting authorization.
• Provide medical guidance and clarifications to providers and enrollees.
• Escalate complex cases to senior medical staff when necessary.
• Maintain accurate records of calls, requests, and authorizations in the system.
• Ensure enrollees receive timely, clinically appropriate care while managing cost-effectiveness.

Requirement:

• Must be a licensed/registered nurse with sound clinical knowledge.
• Strong communication and interpersonal skills.
• Ability to work in a fast-paced call center environment.
• Knowledge of managed care processes and health insurance protocols is an advantage.

Job Info:

• Company: CENTURY MEDICAID SERVICES LIMITED (HMO)
• Position: Claims Officer
• Work Location: Port Harcourt
• Country: NG

How to Submit an Application:

After reading and understanding the criteria and minimum qualification requirements explained in the job information Claims Officer at the office Port Harcourt above, immediately complete the job application files such as a job application letter, CV, photocopy of diploma, transcript, and other supplements as explained above. Submit via the Next Page link below.