HMO Officer at Chion Family Medical Centre

Job Opening: HMO Officer

We are seeking a dedicated and experienced HMO Officer to join our team. The HMO Officer will be responsible for managing relationships with Health Maintenance Organizations (HMOs) and ensuring seamless coordination of healthcare services for patients covered by HMO plans. The ideal candidate will have a strong understanding of HMO processes and regulations, excellent communication skills, and the ability to work collaboratively with healthcare providers, insurance companies, and patients..

Responsibilities:

• Liaise with HMOs to facilitate pre-authorization and verification of insurance coverage for patients.
• Coordinate with healthcare providers to ensure proper documentation and billing procedures for HMO patients.
• Educate patients on their HMO coverage, including benefits, limitations, and co-pays.
• Resolve any billing or coverage disputes with HMOs to ensure timely payment for services rendered.
• Stay updated on HMO regulations and compliance requirements to ensure adherence to industry standards.

Requirements:

• Bachelor's degree in Healthcare Administration, Business Administration, or related field.
• Proven experience working in a similar role within a hospital or healthcare setting.
• In-depth knowledge of HMO processes, insurance verification, and billing procedures.
• Strong communication, negotiation, and problem-solving skills.
• Ability to multitask and work effectively in a fast-paced environment.