HMO Desk Officer at Cedarcrest Hospitals

The Role

• The Health Maintenance Organization Desk Officer reports primarily to the Head, Client Relations.
• Your responsibilities include greeting guests, taking phone calls, sorting correspondence, answering to client inquiries, maintaining the reception area clean and organized, updating records and files, maintaining schedules.

Responsibilities

• Verification of all Insurance patients that presents to the hospital to access care either by confirming that the patient name is on the list or checking in the patient on the Insurance portal. This has to be done on every patient to avoid denial of payment by insurance.
• Getting of approval code for eligible patients by filling in the requested services on the Insurance portal.
• Communicating to the Insurance by writing through email for approval and or any other required information or care to be given to patients.
• Authorization must be gotten at every stage of care i.e. for Consultation, investigations, medications, physiotherapy, radiology etc.
• Sending of discharge report by going to inpatient filter from admission date to discharge date and gather all the services that were rendered to the patient and send to the insurance.
• Sending of Cedarcrest Insurance daily report on all patients that visited the facility both inpatient and outpatient.
• Sending of bills estimate for procedures to Insurances and obtaining proper approvals
• Obtaining medical reports and forwarding them to the various insurance.
• Making sure that all the services given are paid for.
• Following up with billing officers to find out services that approvals were omitted and sorting out payments with the insurance.
• Following up on patients to pay for services that the insurance declined payment for.
• Following up on Doctors to document diagnosis appropriately on their request to reduce claims denials.

Qualifications

• B.Sc degree in Mass communication or any related field
• 2+ years Proven work experience as a Finance Officer or similar role
• Proven experience as HMO desk representative, agent or relevant position
• Familiarity with office machines (e.g. fax, printer etc.)
• Knowledge of office management and basic bookkeeping
• Proficient in English (oral and written)
• Excellent knowledge of MS Office (especially Excel and Word)
• Strong communication and people skills
• Good organizational and multi-tasking abilities
• Problem-solving skills
• Customer service orientation.

Special Conditions

• Employment is contingent on passing a medical screening conducted by the hospital
• The employee will be subject to various testing including but not limited to drug and medical testing throughout the tenure of their employment.

Interested and qualified candidates should send their CV and Cover Letter to: careers@cedarcresthospitals.com using the "Job Title" as the subject of the email.