Case Manager / Billing Officer at Lily Hospitals Limited

Job Summary

• The Case Manager / Billing officer is responsible for the day to day operational activities of the HMO department in the area of communicating relevant information to HMO clients and the organizations service units.
• The role is also responsible for managing the health insurance service desk which includes client servicing and generating bills from HMOs.

Responsibilities

• Developing and improving on existing HMO policies and procedures within the organization to improve the customer/patient experience.
• Engage LILY HMO by communicating usage of their policies within a time frame as provided in the HMO policy of the organization
• Ensure valid and accurate medical reports for all HMO clients are sent on time.
• Approved pre-authorization request to enrollees upon request by the HMO client relation officers on a daily basis
• Collaboration with human resources team to ensure all patients eligibility is cleared.
• Ensure that there is full customer satisfaction for all cadre
• Effective Communication regarding entitlements, coverage and exclusions at all times
• Ensure full compliance and execution with the organizations tariff at all times
• Ensure that all financial and operational data are reported monthly.
• Ensure full patients’ confidentiality.

The Person

• Minimum academic qualification of a B.Sc or HND in a Sciences or other related fields.
• 1 - 3 years relevant work experience in case management or billing.
• Understand basic clinical diagnosis
• Excellent customer service skills
• Excellent business analysis, communication and people management skills
• Full working Knowledge of the Microsoft office package is required especially with spreadsheet software (Excel).
• Great interpersonal skills
• Excellent writing and communication skills.