Claims Vetting Officer At Sterling Health HMO

Sterling Health HMO is a leading National Health Insurance Agency accredited Health Maintenance Organization. Since 2007, we have been committed to providing quality, affordable healthcare services to individuals and businesses across Nigeria every day of the year.

We are expanding our team and inviting applications for the following role:

Position: Claims Vetting Officer

Location: Lagos

Employment Type: Full-time

Role Overview

As a Claims Vetting Officer, you will play a key role in reviewing and evaluating healthcare claims. Your work ensures that our members receive timely and accurate healthcare services while maintaining compliance with insurance guidelines.

Responsibilities

• Review and assess healthcare claims for accuracy, completeness, and eligibility based on Sterling Health HMO policies
• Verify patient eligibility and coverage information
• Apply medical coding standards such as ICD-10 and CPT to review services rendered
• Identify discrepancies, errors, or potential fraudulent claims for further investigation
• Communicate with healthcare providers and members to obtain additional information when necessary
• Process claims accurately and meet established turnaround times
• Use the claims processing system to input, review, and finalize claim decisions
• Maintain detailed and up-to-date records of all claims and related actions
• Follow regulatory requirements and internal policies related to claims handling
• Stay informed about updates in medical coding, billing practices, and insurance regulations
• Work collaboratively with other Claims Department team members and internal units to resolve complex claim issues
• Prepare and submit reports on claims processing activities and trends
• Support the development and improvement of claims processing procedures
• Handle other claims-related duties as assigned

Application Deadline

Application closing date is not specified. Early applications are encouraged.

How to Apply

Interested and qualified candidates should send their CV. Please use the job title as the subject of your email.