About the Role
Daniel Adewole Awe Medical Center is a reputable healthcare facility located in Ilesa, Osun State, dedicated to delivering exceptional primary and secondary healthcare services to our community. We are currently seeking a dynamic, detail-oriented, and experienced HMO Officer to join our professional healthcare administration team on a full-time, on-site basis. In this role, you will serve as the vital link between our medical center and various Health Maintenance Organizations, ensuring seamless healthcare delivery, accurate billing, and optimal patient satisfaction.
Key Responsibilities- Manage and maintain professional relationships with various Health Maintenance Organizations (HMOs) and insurance partners.
- Verify patient insurance coverage, eligibility, and benefits prior to treatment or consultation.
- Coordinate pre-authorizations and treatment approvals promptly with HMO providers to avoid service delays.
- Process, submit, reconcile, and track medical claims to ensure timely reimbursement and minimal financial discrepancy.
- Ensure full compliance with HMO policies, service level agreements, and internal hospital regulations.
- Resolve billing discrepancies and address patient or provider inquiries regarding insurance coverage.
- Bachelor's degree in a relevant field with required professional registration or licensure where applicable.
- Demonstrated experience in HMO operations, medical billing, claims processing, and healthcare reimbursement systems.
- Strong foundational knowledge of medical terminology, clinical workflows, and hospital administrative procedures.
- Exceptional attention to detail, analytical thinking, and problem-solving abilities to manage complex financial and patient data.
- Proficiency in basic computer applications, hospital management software, and electronic health records.
- Effective communication and interpersonal skills for successful collaboration with clinical staff and external HMO representatives.
- Competitive salary commensurate with experience and qualifications.
- Opportunities for professional growth and continuous medical education within a supportive environment.
- Comprehensive health coverage and staff medical care benefits.
- A collaborative, patient-focused work culture in a modern healthcare facility.