Ninja
Retail
SeniorClaimSpecialist
“Senior Claim Specialist at Ninja. Skills: insurance claims processing, rejection analysis, claims reconciliation, Nphies platform, CCHI regulations. manage insurance claims processing. rejection analysis”
What You'll Achieve.
accurate claim submissions; timely financial recovery; compliance with Nphies and CCHI regulations
Industry & Context.
analytical skills
What They're Looking For.
Must Have
Bachelor’s degree in Insurance or related field, Minimum 2 years of experience in insurance claims processing, Previous experience in a pharmacy chain is required, Knowledge of Nphies platform, ICD-10 AM coding, and insurance regulations, analytical and communication skills
What You'll Do.
manage insurance claims processing
claims reconciliation across pharmacy operations
ensure accurate claim submissions
compliance with Nphies and CCHI regulations
timely financial recovery
Review and process insurance claims and e-claims submissions
Analyze claim rejections and coordinate resubmissions with supporting documentation
Ensure compliance with Nphies standards and CCHI regulations
Monitor claim payments
and collection reports
Prepare periodic reports on submissions
Coordinate with internal teams and insurance stakeholders to resolve claim issues
How You'll Work.
Team & Collaboration
work closely with pharmacists, TPAs, and insurance providers; Coordinate with internal teams and insurance stakeholders to resolve claim issues
Communication Scope
communication skills
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