Medical Claims Officer Job Vacancy at Marie Stopes Tanzania – June 2025
Working Hours: Full-time
Location: Dar es Salaam, Tanzania
Organization: Marie Stopes Tanzania (MST)
Department: Clinics
Reports To: Customer Care Manager
Marie Stopes Tanzania (MST) is a Non-Governmental Organization and social enterprise committed to providing high-quality family planning, sexual and reproductive health services across Tanzania. As a key partner to the Government of Tanzania and a member of the Marie Stopes International (MSI) Global Partnership, MST supports the mission of ensuring all women and men in Tanzania have “Children by Choice, Not Chance.”
Our organization is committed to safeguarding children, young people, and vulnerable adults, and expects all staff to uphold this principle.
Job Summary
Marie Stopes Tanzania is seeking a qualified and detail-oriented Medical Claims Officer to join its insurance and billing team. The successful candidate must have a clinical background and experience in medical claims vetting and adjudication. This position is essential for ensuring accurate and timely submission of medical claims to NHIF and private insurers through manual and digital platforms.
Key Responsibilities
- Review and vet inpatient and outpatient claims for accuracy and compliance with Tanzanian insurance policies
- Submit claims electronically through NHIF and private insurance portals
- Monitor claims for rejections, errors, or delays and resolve them promptly
- Evaluate clinical documentation to confirm medical necessity and correct coding as per Tanzania Standard Treatment Guidelines
- Ensure all claims comply with the Ministry of Health, NHIF, and private insurer requirements
- Collaborate with reception, clinical, lab, pharmacy, and billing teams to ensure consistent compliance
- Follow up on pending, denied, or underpaid claims and liaise with insurers for reconciliation
- Maintain comprehensive records of claims and correspondence with insurers
- Train and support staff on claims documentation and compliance best practices
- Generate reports on claims performance, rejections, and trends for internal audits
- Stay informed on changes in NHIF, private insurance policies, and healthcare regulations
Qualifications
- Medical degree or Diploma in Clinical Medicine is mandatory
- Certification, Diploma, or Degree in Insurance or related field is an added advantage
- 2–5 years of experience in medical claims vetting or healthcare insurance in Tanzania
- Registered with the Medical Council of Tanganyika
- Strong understanding of the Tanzanian healthcare system, NHIF workflows, and private insurance operations
- Proficiency in hospital billing systems, electronic health records, and claims platforms
- Strong analytical, communication, and problem-solving skills
- Ability to work independently and collaboratively
Preferred Skills
- Certification in medical coding (e.g., ICD-10)
- Experience with e-claims portals and private insurer platforms
- Knowledge of Tanzanian healthcare compliance and audit procedures
How to Apply
If you meet the criteria and are motivated to contribute to our mission, please send your application with a cover letter explaining your suitability for the role 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
Email: jobs@mst.or.tz
Deadline for applications: Friday, June 13, 2025
Only shortlisted candidates will be contacted.
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