HMO/Billing Officer at Skyhigh Medical Centre

About the job

 HMO & Insurance Management

• Register and verify patient HMO eligibility and benefits before service delivery.
• Liaise with HMO representatives for approvals, service codes, and pre-authorizations.
• Track, document, and manage all HMO-related treatments, investigations, and referrals.
• Ensure that all HMO claims are submitted accurately and on time.

Billing Operations

• Prepare and issue invoices for HMO, private, and corporate clients.
• Accurately capture all billable services and consumables used by patients.
• Monitor and reconcile daily patient bills and revenue against services rendered.
• Identify and correct billing discrepancies before submission.

Claims Management

• Compile, validate, and submit claims to HMOs and corporate clients promptly.
• Track the status of submitted claims and follow up on pending or rejected ones.
• Resubmit or rectify rejected claims with supporting documentation.
• Maintain proper documentation for all claims for audit and review purposes.

Payment Reconciliation

• Reconcile payments received with claims submitted to ensure completeness and accuracy.
• Work closely with the finance team to ensure timely posting of payments and resolution of variances.
• Prepare periodic aging reports and outstanding claims summaries for management.

Reporting & Documentation

• Maintain accurate records of patient accounts, invoices, HMO approvals, and payment remittances.
• Generate daily, weekly, and monthly billing and payment reports.
• Flag issues of non-payment or delayed remittances to the appropriate authority.
• Support audits by providing relevant billing documentation and reconciliations.

Relationship Management

• Serve as the point of contact for all HMO-related inquiries and correspondence.
• Foster strong professional relationships with HMO and corporate account officers.
• Address complaints or issues from patients and clients related to billing.

Requirements

• Bachelor's Degree or HND in Accounting, Finance, Business Administration, or related fields.
• 0-2 years minimum experience in HMO/Billing Officer role.
• Knowledge of HMO operations, health insurance codes, and billing procedures is an added advantage.
• Excellent proficiency in Microsoft Excel and EMR platforms.
• Strong attention to detail and ability to multitask.
• Good communication and interpersonal skills.
•  Willingness to work on a shift basis.