Medical Claims Officer at Marie Stopes Tanzania (MST)

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Marie Stopes Tanzania (MST) Jobs 2025

Medical Claims Officer at Marie Stopes Tanzania (MST) June 2025

SHORT TERM CAREER OPPORTUNITY
Job Type: Full-time
About Us:
Marie
Stopes Tanzania (MST), a Non-Governmental Organization, is a social
enterprise and a leading provider of family planning, sexual and
reproductive health care and allied services. MST is a partner of the
Government of Tanzania and a member of the Marie Stopes International
(MSI) Global Partnership, which operates in over 37 countries worldwide.
MST’s mission is that all women and men in Tanzania will have “Children
by Choice, Not Chance”.

Our organization is committed to
safeguarding and promoting the welfare of children, young people and
vulnerable adults and expects all staff and post holders to share this
commitment.

Job Title: Medical Claims Officer
Department: Clinics
Reports To: Customer Care Manager.
Job Summary:
We
are seeking a qualified and detail-oriented Medical Claims Officer to
join our insurance and billing team. The ideal candidate will have a
medical background (Clinical Officer or Medical Doctor) and experience
in medical claims vetting & adjudication, particularly within the
Tanzanian healthcare and insurance landscape. This role ensures
accurate, compliant, and timely submission of medical claims both
manually and through online platforms to insurance providers.

Key Responsibilities:

• Review
  and vet inpatient and outpatient claim for accuracy, completeness, and
  compliance with Tanzanian insurance policies and guidelines.
• Submit claims electronically via NHIF and private insurance portals, ensuring timely and accurate data entry.
• Monitor online/physical claim submissions for rejections, errors, or delays and take corrective actions promptly.
• Evaluate
  clinical documentation to ensure medical necessity and appropriate
  coding align with the Tanzania Standard treatment guideline.
• Ensure all claims meet compliance standards set by the Ministry of Health, NHIF, and private insurers.
• Liaise with receptionist, clinician, laboratory, pharmacy and billing teams to ensure compliance is achieved.
• Follow up on pending, denied/rejected, or underpaid claims and coordinate reconciliation with insurers.
• Maintain accurate records of claims, correspondence, and payment statuses for each insurance.
• Provide training and support to clinical and administrative staff on documentation and claims best practices.
• Generate regular reports on claims performance, rejections, and trends for internal audits and management review.
• Stay updated on changes in insurance regulations, NHIF policies, and healthcare compliance requirements in Tanzania.

Qualifications:

• Medical degree or Diploma in Clinical Medicineis mandatory.
• Certificate Diploma or Degree any field of insurance will be added advantage.
• Minimum 2–5 years of experiencein medical claims vetting or healthcare insurance in Tanzania.
• Registered with Medical council of Tanganyika.
• Strong understanding of Tanzanian healthcare system, NHIF processes, and private insurance operations.
• Familiarity with hospital billing systems, electronic health records, and online claims platforms.
• Excellent analytical, communication, and problem-solving skills.
• Ability to work independently and collaboratively in a fast-paced environment.

Preferred Skills:

• Certification in medical coding (e.g., ICD-10) is an added advantage.
• Experience with e-claims portal and private insurer platforms.
• Knowledge of Tanzanian healthcare compliance and audit procedures.

MODE OF APPLICATION:
This is Full-time
Job, If you feel that you are able to meet the requirements and you are
motivated enough to be part of the team, please send your applications
including a cover letter detailing your suitability and why you are
interested in this post to the address below.

Head of Human Resources and Administration,
Marie Stopes Tanzania,
11 Majuva Street – Mwenge,
P. O. Box 7072, Dar Es Salaam.
Telephone: +255 22 2774991 / 4
VOIP +255 768 987 780
E-mail : jobs@mst.or.tz

Closing date: All applications should reach the addressee before Friday June 13th, 2025. Go to our Homepage To Get Relevant Information. Only short-listed candidates will be contacted.