About the Role
St Dominic Catholic Hospital, a reputable 64-bed faith-based medical facility committed to Catholic ethics and evidence-based medicine, is seeking a diligent and experienced HMO Officer. In this role, you will be pivotal in bridging the gap between our patients, the hospital, and various Health Maintenance Organizations to ensure seamless healthcare delivery and optimal revenue cycle management.
Key Responsibilities- Verify HMO patient eligibility and coverage using portals before consultations and admissions.
- Secure timely pre-authorizations for consultations, surgeries, admissions, and specialist referrals.
- Collate, prepare, and submit accurate medical claims to partner HMOs while actively tracking outstanding payments and reconciling accounts with hospital finance.
- Serve as the primary point of contact for major HMO providers, ensuring strict compliance with NHIA guidelines and service level agreements.
- Maintain comprehensive databases and generate weekly or monthly reports on patient volume, revenue, and claims reconciliation.
- Resolve patient complaints regarding billing, co-pays, and benefit exclusions with professionalism and empathy.
- Possession of an HND or Bachelor’s Degree in Health Administration, Finance, Nursing, Public Health, or a related discipline.
- Between 1 to 5 years of cognate professional experience working within an HMO, hospital corporate services, or health insurance department.
- Solid understanding of NHIA guidelines, healthcare billing processes, and hospital operations.
- Proficiency in Microsoft Office suite, particularly Excel, alongside familiarity with various HMO portals.
- Demonstrated strength in negotiation, problem-solving, communication, and multitasking under pressure.
- Competitive salary package commensurate with experience and industry standards.
- Opportunities for professional development within a faith-based and values-driven healthcare institution.
- A supportive, collaborative, and ethical working environment focused on holistic patient care.