HMO Desk Officer at Shalina Healthcare

About the job

• The ideal candidate will be detail oriented, and responsible for ensuring smooth interactions between the hospital, Health Maintenance Organizations (HMOs) and patients. The HMO Desk officer will handle patient registration, process HMO approvals, verify coverage and maintain accurate HMO & private patients records while upholding excellent customer service standards.

What you become a part of:

Shalina Diagnostics, an arm of Shalina Healthcare, provides top-tier diagnostic services. As part of our commitment to affordable and accessible healthcare in Africa, the HMO Desk Officer plays a vital role in processing HMO approvals, verify coverage and maintain accurate HMO & private patients records while upholding excellent customer service standards.

What to expect:

• Serve as the primary point of contact for all HMO-related patient interactions.
• Register patients under their respective HMOs and confirm eligibility before consultations or treatments.
• Obtain and process pre-authorisations and approvals from HMO for procedures, medications and investigations.
• Manage proper filing and retrieval of both HMO and general patient records, ensuring easy access when needed.
• Communicate effectively with HMO representatives to resolve queries, discrepancies or approval delays.
• Work closely with the Accounts and Billing team to reconcile HMO claims and ensure accurate submissions.
• Guide patients through their HMO benefits, limitations and required procedures in a polite and professional manner.
• Ensure confidentiality, accuracy and proper arrangement of all HMO-related documents.
• Uphold professional etiquette by greeting staff, patients and visitors courteously and maintaining clear, respectful communication at all times.
• Adhere strictly to hospital policies and procedures regarding patient information and HMO claims.

Essential education, experience and skills:

• Health Information Management, or a related field.
• Minimum of 3 years' cognate experience in HMO management.
• Strong understanding of HMO operations and approval and billing processes.
• Proficiency in Microsoft Excel and accounting software.
• Excellent communication and interpersonal skills.
• High level of accuracy, integrity, and attention to detail .