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REF: 31

ASSISTANT BENEFITS AND CLAIMS OFFICER (18)

Lusaka

Accepting Applications

Department

Health Insurance Services(HIS)

Position Type

Permanent

Experience Required

1 years

Key Responsibilities

The key functions of the role will include but not limited to.

• To timely register new claim submissions from accredited health care providers.
• Track claims through the various subsequent workflows.
• Timely update various claims registers and departmental trackers
• Perform claims reconciliations both between internal workflow stations as well as with the various health care providers.
• Attend to audit & claim queries from healthcare providers.
• Admit all qualifying claims in the claims register immediately on receipt.
• Maintain good business relationship with Health Care Providers and conduct Health Care Provider sensitisation on NHIMA Benefits, Tariffs, and importance of properly filled in claim forms.
• Communicate daily to healthcare providers with claims submission omissions.
• To be able to scan, batch and index claims prior to adjudication.
• To prepare daily, weekly, claims status reports.
• To manage the weekly claims adjudication schedule and submission.
• Participate in any other claims process roles as demand arises and as guided by the Supervisor.
• Conduct any other roles as assigned by the Supervisor.

Education Requirements

• Grade twelve (12) School certificate with 5 ‘O’ levels with credit or better including Mathematics and English Language (ZAQA Certified).
• Diploma in a relevant field (ZAQA Certified).
• Degree in relevant field will be an added advantage (ZAQA Certified).
• More than six (6) Months relevant work experience in a similar role,
• Certificate in management of a health insurance scheme, compensation fund or social security will be an advantage

Required Skills

• Excellent knowledge of marketing and customer service,
• Good oral and written communication skills,
• Must be computer literate with MS Office applications skills,
• Attention to detail, and
• Excellent analytical skills.

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Applications close May 12, 2026 at 23:59

National Health Insurance Management Authority

Application Link:https://careers.nhima.co.zm/openings

COUNTRY: Zambia

• To timely register new claim submissions from accredited health care providers.
• Track claims through the various subsequent workflows.
• Timely update various claims registers and departmental trackers
• Perform claims reconciliations both between internal workflow stations as well as with the various health care providers.
• Attend to audit & claim queries from healthcare providers.
• Admit all qualifying claims in the claims register immediately on receipt.
• Maintain good business relationship with Health Care Providers and conduct Health Care Provider sensitisation on NHIMA Benefits, Tariffs, and importance of properly filled in claim forms.
• Communicate daily to healthcare providers with claims submission omissions.
• To be able to scan, batch and index claims prior to adjudication.
• To prepare daily, weekly, claims status reports.
• To manage the weekly claims adjudication schedule and submission.
• Participate in any other claims process roles as demand arises and as guided by the Supervisor.
• Conduct any other roles as assigned by the Supervisor.

• Excellent knowledge of marketing and customer service,
• Good oral and written communication skills,
• Must be computer literate with MS Office applications skills,
• Attention to detail, and
• Excellent analytical skills.

• Grade twelve (12) School certificate with 5 ‘O’ levels with credit or better including Mathematics and English Language (ZAQA Certified).
• Diploma in a relevant field (ZAQA Certified).
• Degree in relevant field will be an added advantage (ZAQA Certified).
• More than six (6) Months relevant work experience in a similar role,
• Certificate in management of a health insurance scheme, compensation fund or social security will be an advantage