About the Role
St Dominic Catholic Hospital is a 64-bed faith-based medical facility committed to excellence in primary and secondary healthcare through evidence-based medicine and Catholic medical ethics. We are currently seeking a dynamic and detail-oriented HMO Officer to oversee all Health Maintenance Organization operations, ensure seamless patient service delivery, and optimize revenue collection.
Key Responsibilities- Verify HMO patient eligibility and coverage using portals before consultation or admission.
- Obtain timely pre-authorizations for consultations, surgeries, admissions, and referrals.
- Prepare, collate, and submit accurate medical claims to partner HMOs while following up on outstanding payments.
- Serve as the primary liaison between the hospital and health maintenance organizations such as AXA Mansard, Hygeia, Redcare, and Avon.
- Resolve HMO patient complaints regarding benefits, co-pays, and service exclusions while ensuring adherence to NHIA guidelines.
- Maintain comprehensive databases and generate weekly and monthly reports on HMO patient volume, revenue, and claims reconciliation.
- Possession of an HND or Bachelor Degree in Health Administration, Finance, Nursing, Public Health, or a related field.
- 1 to 5 years of proven experience working within an HMO, hospital corporate services, or insurance department.
- Strong understanding of NHIA guidelines, hospital billing systems, and HMO operational workflows.
- Proficiency in Microsoft Office Suite, particularly Microsoft Excel, and various HMO portal navigation.
- Excellent communication, negotiation, interpersonal, and problem-solving competencies.
- Competitive monthly salary ranging from N90,000 to N130,000.
- Opportunity to work in a reputable, values-driven healthcare institution.
- Continuous professional development and supportive working environment.