Job Status: Active
One of our client is looking to hire Medical Reimbursement Officer (Medical Insurance)
Key Responsibilities
-Review and process medical reimbursement claims for accuracy, eligibility, and clinical validity
-Verify supporting documents (invoices, prescriptions, medical reports) to ensure compliance with policy and benefits
-Ensure adherence to insurance regulations, internal protocols, and medical guidelines
-Coordinate with brokers, clients, and policyholders to clarify or obtain required documentation
-Identify and escalate fraudulent, abnormal, or non-compliant cases
-Provide evidence-based recommendations for claim approvals or rejections
-Work closely with Finance and Claims teams to ensure timely settlement of approved claims
-Handle claim disputes fairly and in line with company policies
Requirements
-Bachelor’s degree in Allopathic Medicine, Pharmacy, Nursing, Physiotherapy, Dentistry, or other medical/paramedical fields
-Minimum 2 years of relevant experience in medical insurance claims, reimbursement, or related function
-Strong knowledge of medical treatments and terminology
-Skilled in reviewing reimbursement documents and medical records with high accuracy
-Excellent communication skills for engaging with brokers, clients, and policyholders
-Strong judgment and problem-solving skills for complex cases
-Ability to detect irregularities and analyze claim trends
How to Apply
Interested candidates may apply by emailing their updated profiles to recruitment@metierme.net with the subject line:
‘Officer – Medical Reimbursement’
Please note that only shortlisted candidates will be contacted for further discussion.