HMO Officer

Westcare Specialist Hospital

Westcare Specialist Hospital is a multidisciplinary healthcare organization committed to providing quality, compassionate, and accessible healthcare services to patients. With a wide range of medical specialties, surgical services, diagnostic services, and healthcare support services, we are dedicated to delivering excellent patient care through qualified professionals, modern medical equipment, and a patient-centered approach.

Our vision is to be a leading multidisciplinary healthcare organization in West Africa, while our mission is to serve humanity, pursue excellence, uphold integrity, and provide quality healthcare services.

We are recruiting to fill the position below:

Job Title: HMO Officer

Location: Egbeda, Lagos

Employment Type: Full-time

Description

• We are seeking a competent, detail-oriented, and experienced HMO Officer to join our team.
• The ideal candidate will be responsible for managing HMO-related processes, coordinating with HMO partners, and ensuring seamless healthcare services for eligible patients.

Key Responsibilities

• Liaise with HMOs, retainerships, and corporate organizations to confirm patient eligibility and obtain pre-authorizations.
• Ensure proper documentation and processing of bills for HMO and insurance patients.
• Monitor and follow up on outstanding claims to ensure timely reimbursement.
• Educate patients on HMO coverage, exclusions, procedures, and other relevant information where necessary.
• Act as an intermediary between the hospital, clients, and HMO partners.
• Obtain approval codes for eligible patients by accurately entering requested services on HMO portals.
• Communicate with HMOs via email and other approved channels regarding approvals, patient care, required information, and other necessary matters.
• Maintain accurate records of HMO transactions, approvals, claims, and correspondence.
• Ensure compliance with HMO policies and the hospital's internal procedures.

Requirements

• HND or Bachelor’s Degree in any relevant field.
• 3–4 years of relevant experience in HMO operations, healthcare administration, insurance, or a related role.
• Good knowledge of HMO processes, claims management, and approval procedures.
• Excellent communication and interpersonal skills.
• Strong attention to detail and documentation skills.
• Ability to work effectively in a hospital environment and liaise professionally with patients and HMO representatives.
• Applicants must reside within Egbeda and its environs.

Application Closing Date

Not Specified.