CLAIMS MANAGEMENT OFFICER AT REVOLUTIONARY HEALTH MAINTENANCE ORGANIZATION |CLAIMS MANAGEMENT OFFICER JOB IN ABUJA

About Company:

RevoHealth (RVH) is a Nigerian Health Maintenance Organisation (HMO) established as a transformative health financing initiative committed to redefining access to healthcare across Africa. We are on a mission to drastically reduce out-of-pocket healthcare payments, eliminate financial barriers, and deploy technology to overcome physical access challenges, making healthcare truly accessible to underserved populations.

Job Description:

• The Claims Management Officer manages the end-to-end claims process, ensuring timely, accurate, and fraud-free claims settlement while optimising cost efficiency and enhancing customer satisfaction.
• They are accountable for claims cost efficiency and control, accuracy and integrity of claims payments, fraud prevention and detection, customer experience in claims handling, provider payment discipline and compliance, and alignment with underwriting assumptions (loss ratio control).

Responsibilities
This role focuses on:

• Overseeing end-to-end claims processing and adjudication
• Ensure timely and accurate claims settlement
• Implement cost control and utilisation management
• Detect and prevent fraud and abuse
• Manage provider relations and billing integrity
• Handle complaints and claims disputes
• Ensure compliance with NHIA and internal policies.

Requirements:

• Bachelor’s Degree in Medicine, Nursing, Pharmacy, Insurance, or related field (preferred)
• Professional certification in healthcare management, insurance, or risk (preferred)
• Minimum 4 years experience in claims management or healthcare operations
• Strong knowledge of NHIA guidelines, provider tariffs, and healthcare systems
• Experience in claims adjudication, fraud management, and utilization review.

Key Competencies:

• Claims Adjudication Expertise – Deep understanding of medical claims processes
• Analytical Skills – Ability to detect anomalies and fraud patterns
• Cost Management – Strong focus on cost containment strategies
• Attention to Detail – Accuracy in claims review
• Regulatory Knowledge – Understanding of NHIA and healthcare compliance
• Problem-Solving – Ability to resolve disputes effectively
• Stakeholder Management – Strong engagement with providers and customers.

Salary

Application Closing Date: 19th April, 2026

Application Instructions:

CLICK ON THE LINK BELOW TO APPLY