HMO Officer at Westcare Specialist Hospital
Job Description
Westcare Specialist Hospital is seeking a qualified and experienced HMO Officer to manage relationships with Health Maintenance Organizations (HMOs), insurance providers, and corporate clients. The ideal candidate will ensure smooth processing of patient approvals, claims management, and effective communication between healthcare stakeholders while maintaining accurate documentation and compliance with HMO procedures.
Location: Egbeda, Lagos
Employment Type: Full-time
Job Responsibilities
• Liaise with HMOs, retainership clients, and corporate organizations to verify patient eligibility and obtain pre-authorizations for medical services.
• Process and maintain accurate documentation for HMO and insurance patient bills and claims.
• Monitor outstanding claims and follow up with relevant HMOs and insurance providers to ensure prompt reimbursement.
• Educate patients on HMO coverage, exclusions, benefits, and required procedures when necessary.
• Serve as a liaison between patients, healthcare providers, and HMO partners to facilitate seamless service delivery.
• Obtain approval codes for eligible patients by submitting requested services through HMO portals.
• Communicate with HMOs through email and other approved channels regarding approvals, patient care requests, and additional information requirements.
• Maintain accurate records of approvals, claims, and correspondence with HMO partners.
Job Requirements
• HND or Bachelor’s Degree in a relevant field.
• Minimum of 3 to 5 years of experience in HMO administration, healthcare insurance, or a related role.
• Good understanding of HMO operations, claims processing, and healthcare administration procedures.
• Strong communication, documentation, and interpersonal skills.
• Proficiency in using HMO portals, email correspondence, and relevant computer applications.
• Applicants must reside in Egbeda, Lagos, or nearby areas.
Application Method
Interested and qualified candidates should send their CV using “HMO Officer” as the subject of the email.
