Relationship Officer at Cedarcrest Hospitals

Purpose of the Role

• The relationship officer verifies 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. Get approval code for eligible patients by filling in the requested services on the Insurance portal etc.
• The relationship officer also handles the concerns of patients and to ensure timely and scheduled response to patients and clients. Every patient whether private paying or insured will have a relationship officer assigned to them.

The relationship officers will be assigned to patient’s in the following categories:

• Private and VIP patients
• HMO Patient’s
• Corporate patients.

Key Performance Areas:

• Welcoming patients upon arrival to the hospital
• Inform and advise patients on services and answer questions where necessary
• chaperone and guide patient’s through the steps at each service point
• Follow up on patient’s medical reports
• Follow up on approval codes for patients
• Request for credit limits for patient’s where necessary
• Ensure medical officers fill admissions notification forms which must reach all HMO’s and Corporate organizations within 24 hours
• Give patient discharge notifications to HMO’s and corporate organizations
• Give patient admission notifications to HMO’s and corporate organizations
• 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.
• Perform any other task/functions that maybe assigned.

Hierarchy:

• This role reports to the Head of Client Services.

Education, Certification and Experience Requirements

• Bachelor's Degree or HND in Mass Communication, Secretarial study or related field.
• 2 years plus experience.
• Nysc discharged certificate

Profile Requirements:

• Proven experience as an hospital admissions officer or similar position
• Experience in customer service is required
• Proficient in MS Office and call center equipment/software programs
• Outstanding communication and interpersonal skills
• Excellent organizational and leadership skills with a problem-solving ability
• Positive and patient
• High confidentiality, integrity and accountability.
• Highly professional and well presented.
• Flexible and mature approach with ability to work unsupervised.
• Bright, confident personality
• Strong coaching and leadership skills, ability to motivate employees.
• Proficiency with the necessary technology, including computers, software applications, phone systems, etc.
• Polite, professional phone voice/manners.