Elucid Uganda
Title: Medical Claims Manager
Type: Full time
Desired start date: June 23, 2025
Location: Kampala/Masaka
About Elucid Social-Uganda:
At Elucid, we make human health benefit supply chains.
We offer a unique solution that enables companies to generate high-quality data for sustainability and compliance reporting, while improving the health and living standards of farming households.
By translating actions into compelling data, we help supply chains gain consumer trust and meet regulations.
Job Description:
We are seeking a skilled and experienced Medical Claims Manager to join our team in Uganda.
The ideal candidate will be responsible for overseeing the entire medical claims process, from submission to resolution, ensuring accuracy, efficiency, and adherence to relevant guidelines and regulations.
Responsibilities:
- Supervise a team of Claims Officers providing guidance, training, and support as needed.
- Review and evaluate incoming medical claims to ensure completeness, accuracy, and compliance with policies and regulatory requirements.
- Investigate and resolve complex or disputed claims, collaborating with internal teams, healthcare providers, and insurance companies.
- Develop and implement efficient claims processing procedures and workflows to optimise productivity and minimise errors.
- Stay informed about changes in healthcare regulations, insurance policies, and billing codes, and ensure that the claims team is updated accordingly.
- Monitor claims processing metrics and performance indicators, identifying areas for improvement and implementing strategies to enhance efficiency and accuracy.
- Serve as a point of contact for escalated inquiries or complaints related to medical claims, and work towards timely resolution and customer satisfaction.
- Collaborate with operational teams to streamline processes and improve overall service delivery.
- Prepare and present reports on claims processing activities, trends, and outcomes as needed.
- Ensure compliance with national data protection & privacy laws as well as GDPR and other relevant privacy laws in handling sensitive patient information.
- Establish and maintain relationships with healthcare providers
Requirements:
- Bachelor’s degree in healthcare administration, business administration, accounting, finance or a related field
- Proven experience 5 years or more in medical claims management or a similar role within the healthcare industry.
- In-depth knowledge of medical billing and coding practices, insurance policies, and healthcare regulations.
- Strong leadership and managerial skills, with the ability to motivate and develop a high-performing team.
- Excellent analytical and problem-solving abilities, with a keen attention to detail.
- Effective communication and interpersonal skills, with the ability to interact professionally with internal and external stakeholders.
- Proficiency in using claims processing software and other relevant computer applications.
- Ability to prioritise tasks, meet deadlines, and work effectively in a fast-paced environment.
Additional Information:
- This is a full-time position based in either Kampala or Masaka. Travel to project sites and other locations may be required periodically.
- The position offers a competitive salary and benefits package commensurate with experience and qualifications.
- Elucid Social Uganda is an equal opportunity employer and values diversity in its workforce.
How to apply:
Please send applications (CV and cover letter) to: gratian.nareebah@elucid.health
Join us in making a difference in the health and well-being of farming households and rural communities.
