Job Title: Medical Review Specialist
Location: [Lekki Lagos, Nigeria]
Job Type: Full-Time
Industry: Healthcare / Medical / Health Insurance
About the Role:
We are seeking a detail-oriented and experienced Medical Review Specialist to join our dynamic team. The ideal candidate will be responsible for reviewing medical claims, patient records, and related documents to ensure accuracy, medical necessity, and compliance with regulatory standards.
Key Responsibilities:
- Review and evaluate medical records, treatment plans, and claims for accuracy and completeness.
- Assess the necessity and appropriateness of medical procedures and services.
- Provide recommendations on claims approvals, denials, or further documentation.
- Collaborate with physicians, healthcare providers, and internal teams for clarification and documentation review.
- Ensure compliance with insurance policies, coding guidelines (ICD-10, CPT, etc.), and regulatory requirements.
- Prepare detailed reports and documentation for internal and external audits.
Requirements:
- Bachelor's degree in Nursing, Medicine, Pharmacy, or other health-related fields (Registered Nurse, MBBS, or BPharm preferred).
- Minimum of 2 years’ experience in medical claims review, utilization review, or clinical documentation.
- Strong knowledge of medical terminology, ICD/CPT coding, and healthcare regulations.
- Attention to detail and excellent analytical skills.
- Good communication and decision-making abilities.
- Proficiency in Microsoft Office and medical software systems.
Preferred:
- Certification in medical coding or health information management is an added advantage.
What We Offer:
- Competitive salary
- Health insurance
- Career growth opportunities
- Friendly and professional work environment
How to Apply:
Interested and qualified candidates should submit their CV and a cover letter to jobs.hamthelholdings@gmail.com with the subject line:
“Application for Medical Review Specialist – Your Name”
Job Type: Full-time
Application Deadline: 28/07/2025