Claims & Clinical Audit Officer
AI summary
Cosmopolitan Health Insurance is hiring a Claims & Clinical Audit Officer in Accra, Greater Accra. The role involves reviewing medical claims, conducting clinical audits, checking documentation accuracy, identifying billing irregularities and fraud indicators, and engaging healthcare providers to resolve claims issues. It is a full-time mid-level position requiring 3–5 years of experience, with applications closing on 9 October 2026.
- Full-time mid-level role in Accra, Greater Accra
- Requires 3–5 years of experience
- Focus on claims review, clinical audits and fraud detection
- Reports to Head, Medical Services & Claims
- Application deadline is 9 October 2026
AI job guide
Use this guide to check salary signals, requirements, documents, application steps and safety before you apply.
AI salary guide
Source salary availableThe source lists Not disclosed. Confirm the final pay, benefits, contract terms and allowances directly with the employer before accepting an offer.
Can you qualify for this role?
- Required3+ years of relevant experienceThe job post includes a minimum experience signal.
- RequiredEducation or certification mentioned in the postThe captured text mentions education, a diploma, certificate, or licence.
- PreferredPractical evidence in internship, part_time, financeThe tags and summary point to skills connected with this role.
- RequiredAvailability to work in AccraThe vacancy is associated with this location.
- UnclearComfort with the Full Time contract termsConfirm hours, duration, probation and benefits at the original source.
Documents to prepare
- Likely requiredUpdated CV
- Role specificCover letter or short employer message
- OptionalProfessional references
- Role specificAcademic or professional certificates
- VerifyID or passport only after verifying the employer
Application tips for this job
- Place your strongest Claims & Clinical Audit Officer evidence in the first half of your CV.
- In your cover letter or employer message, connect your experience to Cosmopolitan Health Insurance and the role in Accra.
- Add concrete examples related to internship, part_time, finance, ideally with measurable outcomes or clear responsibilities.
- Follow the instructions from JobHub Ghana; avoid sending documents to unofficial contacts or copied links.
- Confirm the deadline, interview location and employer contact before sharing personal documents.
- Plan to submit before the listed deadline: 2026-10-09.
Source and safety check
- JobHub Ghana
- Original source link available
- Application method is clear
- Deadline is available: 2026-10-09
- No major risk signal was detected in the captured text.
Never pay for interviews, shortlisting, medical checks, uniforms, or job placement. Confirm every application at the original source before sharing personal documents. Report suspicious listing.
Interview preparation
- What experience makes you a strong fit for this Claims & Clinical Audit Officer role in internship, part_time?
- How have you handled responsibilities similar to those in this job post?
- Are you available to work in Accra under the listed contract or schedule?
- Prepare examples with clear responsibilities, tools used and measurable outcomes.
- Review the source and research Cosmopolitan Health Insurance before the interview.
Ask what the first priorities will be in the role and how success will be measured.
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Original source description
Job Reference
JHG-2026-629868
Not disclosed
Vacancies
1
09 Oct 2026
Job Type: Full-time
Accra, Greater Accra
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JobHub Ghana Summary
Claims & Clinical Audit Officer is a Full-time opportunity at Cosmopolitan Health Insurance based in Accra, Greater Accra, listed under Healthcare & Medical. Applications close 09 Oct 2026.
Key Details to Review
Cosmopolitan Health Insurance
Accra, Greater Accra
Job type: Full-time
Category
Healthcare & Medical
Experience level
Mid Level (3-5 years)
Not disclosed
Application deadline
09 Oct 2026
Role Details
Cosmopolitan Health Insurance is hiring a Claims & Clinical Audit Officer for its Medical Services & Claims function in Accra. The role is suited to a health professional or claims-audit practitioner who can review provider claims carefully, check clinical documentation, identify billing irregularities and support cost control without compromising appropriate care for members.
Role details
Department or business unit: Medical Services & Claims.
Reporting line: Head, Medical Services & Claims.
Application deadline: 9 October 2026.
Key responsibilities
- Review medical claims submitted by healthcare providers and confirm that the billed services are accurate, supported and aligned with approved benefit structures.
- Conduct clinical audits to test medical necessity, treatment appropriateness, tariff compliance and completeness of supporting records.
- Identify duplicate claims, overbilling, incorrect coding, inconsistent documentation and possible fraud indicators for further review.
- Assess diagnoses, treatment plans, medical records and related documents before claims are cleared or queried.
- Engage healthcare providers professionally to resolve claims questions, missing documentation and billing discrepancies.
- Prepare audit findings, claims review reports and recommendations for corrective action or process improvement.
- Support cost-containment initiatives while helping protect the quality and appropriateness of healthcare services delivered to scheme members.
- Work with internal teams across medical services, claims, finance, client service and other units where claims decisions require coordinated follow-up.
Requirements
- Bachelor's degree in Medicine, Nursing, Pharmacy, Health Information Management or another relevant health discipline.
- At least two years of relevant experience in medical claims, clinical auditing, claims adjudication, healthcare billing review or a closely related role.
- Sound understanding of medical terminology, claims review processes, healthcare billing practices and provider documentation.
- Strong analytical, investigative and problem-solving ability, with the confidence to question unusual claims patterns or unsupported charges.
- Good Microsoft Office skills, especially Excel, for claims checks, audit summaries and report preparation.
- High level of integrity, confidentiality, accuracy and attention to detail when handling member, provider and claims information.
- Ability to communicate clearly with healthcare providers, internal departments and clients while resolving claims issues professionally.
Knowledge and Skills
Clinical judgement and documentation review.
Claims validation and tariff-compliance awareness.
Fraud, waste and abuse sensitivity.
Report writing and corrective-action follow-through.
Confidential handling of medical and claims data.
Application documents
Cover letter.
Updated CV.
Important notes
Only one listing is needed because the flyer and PDF refer to the same Claims & Clinical Audit Officer vacancy.
The employer did not state a separate online application form; applicants should use the email route exactly as advertised.
How to apply
Send your cover letter and CV to
[email protected]
by 9 October 2026.
JobHub Ghana Application Notes
Review Claims & Clinical Audit Officer against your experience before applying to Cosmopolitan Health Insurance. A focused application usually performs better than a generic CV.
Send your application to the listed email address with a clear subject line that includes the role title.
Tailor your CV to the responsibilities, qualifications, and skills Cosmopolitan Health Insurance lists for this role.
Highlight achievements, tools, industries, or training that match the employer's requirements.
This listing closes 09 Oct 2026, so plan to submit well before then.
Claims Processing
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Job Overview
Job Reference
JHG-2026-629868
Not disclosed
Vacancies
1
09 Oct 2026
Job Type: Full-time
Accra, Greater Accra
Apply via Email
Want to track your applications, save jobs, and get alerts?
Create a free account
See something inaccurate, expired, or suspicious?
Sign in to report this job
About the Employer
Cosmopolitan Health Insurance
Health Insurance
Cosmopolitan Health Insurance is a Ghanaian-owned private health insurer licensed under the National Health Insurance Act 852. The company provides health insurance, preventive care, claims administration and related healthcare-financing solutions for individuals, SMEs, NGOs and corporate organisations in Ghana.
View Company Profile
Apply via Email