HMO Officer

About This Role Westcare Specialist Hospital is recruiting an HMO Officer at its facility in Egbeda, Lagos State. This full-time healthcare administration role manages Health Maintenance Organization (HMO) operational workflows, portal approval codes, pre-authorizations, claims billing, and partner relations. Key Responsibilities

Portal Approvals & Pre-authorizations: Verify patient eligibility, input service requests on HMO portals, and secure approval codes for clinical procedures. Claims Billing & Reimbursements: Prepare billings for HMO and corporate retainership patients, track claims, and follow up to secure prompt reimbursements. HMO & Client Liaison: Serve as the primary intermediary between the hospital, HMO representatives, and patients regarding coverage, exclusions, and authorizations. Documentation & Compliance: Maintain records of approvals, claims, and correspondence while ensuring compliance with hospital policies and HMO guidelines.

Requirements & Qualifications

Core Competencies: HMO portal management, pre-authorization workflows, claims reconciliation, patient advisory, and healthcare documentation. Key Attributes: Attention to detail, clear written and verbal communication, and the ability to operate effectively in a fast-paced hospital setting. Geographic Proximity: Applicants must reside within Egbeda or neighboring areas in Lagos State.

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