HMO Billing Officer Job at Syx-Brij Nigeria Limited

Syx-Brij Nigeria Limited - Our client, Adia Hospital, a modern private hospital committed to providing exceptional healthcare services to the community, is recruiting a highly motivated and skilled individuals to fill the position below:

Job Position: HMO Billing Officer 

Job Location: Ikorodu, Lagos
Employment Type: Full-time

Responsibilities

• HMO Liaison:

  
  
  • Serve as the primary point of contact between Vima Hospital and Health Maintenance Organizations.
  • Manage communication, negotiations, and relationship-building with HMO representatives.

• Verification and Authorization:

  • Verify patient eligibility and coverage with HMOs.
  • Obtain necessary authorizations for medical procedures, tests, and treatments covered by HMO plans.

• Billing and Claims:

  • Ensure accurate and timely submission of patient claims to HMOs.
  • Coordinate with the billing department to resolve any discrepancies or issues related to HMO billing.

• Documentation and Record-Keeping:

  • Maintain comprehensive and up-to-date records of HMO-related transactions, authorizations, and communications.
  • Prepare reports on HMO utilization, claims, and reimbursement.

• Educational Outreach:

  • Educate patients on their HMO coverage, benefits, and responsibilities.
  • Provide guidance on navigating HMO processes and requirements.

• Conflict Resolution:

  • Address and resolve any issues or disputes between Lifeshade Hospital and HMOs.
  • Collaborate with internal departments to ensure compliance with HMO agreements.

• Compliance:

  • Stay abreast of changes in HMO policies, regulations, and industry trends.
  • Ensure hospital practices align with HMO contractual agreements and regulatory requirements.

Qualifications

• Bachelor's Degree in Healthcare Administration, Business Administration, or a related field can be a bonus.
• Proven experience working in a similar role within the healthcare industry.
• In-depth knowledge of HMO processes, policies, and regulations.
• Strong communication and negotiation skills.
• Detail-oriented with excellent organizational and problem-solving abilities.
• Ability to work collaboratively in a fast-paced healthcare environment.

Remuneration

• Competitive salary and benefits package, including health insurance, retirement plan, and vacation time.