Apex Health Insurance Limited Insurance Jobs in Accra
✅ Job Alerts Activated
You'll now receive future job opportunities instantly.
Thinking about applying?
Before you submit your application, take a moment to go through all the details carefully.
Scroll down to read the full job description, including responsibilities, requirements, and benefits — and see if it’s the right fit for you.
This is a full-time on-site position for a Claims Vetting Officer, based in Accra. The Claims Vetting Officer will be responsible for reviewing, validating, and analyzing insurance claims, ensuring compliance with company policies and industry regulations. Day-to-day tasks include evaluating submitted claims, verifying their accuracy and eligibility for approval, and ensuring timely processing. The officer will also liaise with clients and healthcare providers, resolve claims-related inquiries, and contribute to improving claims management processes.
Key Responsibilities
- Review and vet medical claims submitted by accredited providers for completeness, accuracy, and policy compliance
- Verify eligibility, benefit limits, tariffs, and treatment appropriateness before approval
- Detect irregularities, overbilling, duplicate claims, and potential fraud indicators
- Liaise with healthcare providers and internal teams to resolve claim discrepancies
- Ensure claims are processed within defined turnaround times and service standards
- Maintain accurate records and documentation for audit and compliance purposes
- Support provider education on claims submission standards and documentation requirements
- Generate periodic reports on claims trends, variances, and exceptions
- Uphold confidentiality and data protection standards in handling member information
ADVERTISEMENT - CONTINUE READING BELOW ↓
CONTINUE BELOW ↓
Qualifications & Requirements
- Bachelor’s degree in Health Information Management, Nursing, Pharmacy, Medicine, Insurance, or a related field
- Licensed medical professionals are encouraged to apply
- Minimum 2–4 years’ experience in claims vetting, medical auditing, or health insurance operations
- Excellent Analytical Skills for evaluating and verifying claims
- Exceptional Communication skills, both written and verbal, to liaise with stakeholders effectively
- Proficiency in Microsoft Office Suite and claims management software is an advantage
- Strong understanding of Ghana’s health insurance framework and NHIA requirements
- Sound knowledge of medical terminology, treatment protocols, and billing practices
- Highly attentive to detail with strong analytical and investigative abilities.
- Proficiency in Microsoft Office and claims management systems
- Excellent communication and stakeholder management skills
- Integrity, discretion, and sound judgment
👉 STOP: Ready to Apply?
Don't miss out on this opportunity! Carefully review the job details one last time. Once you're ready, scroll down to the bottom of this page to access the How to apply button.
Hurry—applications for this cycle are closing soon!← View More Insurance Jobs
✅ Sales Executives & Financial Planners - Pinnacle Life Insurance