Claims Management in Health Insurance and Managed Care Course
Course Overview
At the end of this training participants will be able to:
• List the steps in health insurance claims process
• understand the strategic positioning of claims management;
• identify the linkage between claims processing and customer relationship management
• identify the different categories of claims and financial management
• apply claims inventory control strategies
• describe common claims management problems and know how to avoid them
• contrast traditional and modern trends in claims management
Training Format:In-class, Virtual, In-house
Location:Lagos, Accra, Nairobi, Kigali
Language:English, French
Nigeria Price:
₦330000
Int'l., (Nigeria) Price:
$1000
Ghana Price:
$4000
Kenya Price:
$5500
Rwanda Price:
$6000
Nigeria Price:₦330000
Int'l., (Nigeria) Price:
$1000
Ghana Price:
$4000
Kenya Price:
$4000
Rwanda Price:
$4000
Nigeria Price: ₦330000
Int'l., (Nigeria) Price:
$1000
Ghana Price: $4000
Kenya Price: $4000
Rwanda Price: $4000
• Claims: positioning, purpose, and opportunities
• Pre-authorizations and claims payment
• Claims Operations Management
• Health Insurance Claims: the process
• Types of Claims
• Organizational structure and staffing
• Claims Staffing Ratio
• Management of claims inventory
• Claims pending factors
• Types of reimbursement arrangements and claims management
• Claims Categorization
• Workflow design of claims processing
• Productivity and quality management
• Managing claims TAT
• The Functional link between the claims payment process and the authorization
• Claims coordination with other departments
• Claims business functions
• Common Claims management problems and how to avoid them
• Handling multiplicity of HCP fee schedules
• Claims processing and information technology
• Outsourcing claims processing
• Claims management and customer relationship management
1ST BATCH: Tuesday, March 3, 2026 — Friday, March 6, 2026.
2ND BATCH: Tuesday, July 7, 2026 — Friday, July 10, 2026.
3RD BATCH: Tuesday, November 3, 2026 — Friday, November 6, 2026.
The training methodology integrates lectures, interactive discussions, collaborative group exercises, and
illustrative examples. Participants will acquire a blend of theoretical insights and hands-on practical
experience, emphasizing the application of learned techniques. This approach ensures that attendees return
to their professional environments equipped with both the competence and self-assurance to effectively
implement the acquired skills in their responsibilities.
