About the Role
Westcare Specialist Hospital, established in 1998, is dedicated to delivering exceptional healthcare services to our community. We are currently looking for a diligent and experienced HMO Officer to manage our Health Maintenance Organization activities and ensure seamless coordination between the hospital, HMOs, corporate clients, and patients. The ideal candidate will facilitate smooth service delivery according to patient coverage while maintaining accurate documentation, authorizations, billing, and claims processing.
Key Responsibilities- Manage communication and build strong professional relationships with HMOs and corporate clients.
- Verify patients’ HMO eligibility, benefit plans, and coverage levels upon presentation.
- Process timely pre-authorizations and secure approval codes for medical procedures and treatments.
- Prepare, package, and submit accurate HMO bills and claims within stipulated deadlines.
- Follow up proactively on outstanding claims and pending payments to ensure steady revenue flow.
- Maintain comprehensive, accurate HMO records and documentation for auditing and reporting.
- Attend professionally to HMO-related patient enquiries, escalations, and complaints.
- Liaise closely with various hospital departments, including pharmacy, nursing, and billing, to ensure smooth daily HMO operations.
- HND or Bachelor’s Degree in Nursing, Health Administration, Business Administration, or a related field.
- 2 to 4 years of proven professional experience working in an HMO, hospital administration, or medical billing role.
- Strong proficiency in navigating various HMO portals and managing end-to-end claims processing.
- Excellent interpersonal, communication, documentation, and customer service skills.
- Good computer literacy, including working knowledge of Microsoft Office Suite and hospital management software.
- Competitive salary package commensurate with experience.
- Opportunities for professional growth and career advancement within a reputable hospital group.
- Comprehensive health insurance and medical benefits for staff.
- A supportive, collaborative, and professional working environment in Lagos.