HMO Desk Officer
Job summary
An HMO Desk Officer is responsible for managing the relationship between patients, healthcare providers, and Health Maintenance Organizations (HMOs) to ensure seamless access to healthcare services. The role involves verifying patient eligibility, obtaining treatment authorizations, and coordinating referrals.
Job descriptions & requirements
- Responsibilities:
- Verify patients' HMO enrollment and eligibility status.
- Process and obtain authorization codes for consultations, investigations, admissions, and procedures.
- Liaise with HMOs regarding approvals, referrals, and claims-related issues.
- Register and attend to HMO patients promptly and professionally.
- Maintain accurate records of HMO transactions and patient information.
- Prepare and submit required reports and documentation.
- Resolve complaints and inquiries from patients and HMOs.
- Monitor utilization of HMO services and ensure compliance with HMO guidelines.
- Follow up on pending approvals and authorization requests.
- Collaborate with doctors, nurses, pharmacists, and other hospital departments to facilitate patient care.
Responsibilities:
- Bachelor's degree or Higher National Diploma (HND) in Health Information
- Management, Public Health, Nursing, Hospital Administration, Business Administration, or a related field.
- Previous experience in healthcare administration, health insurance, customer service, or HMO operations is an advantage.
- Proficiency in Microsoft Office applications (Word, Excel, Outlook).
- Good understanding of health insurance and HMO processes.
- Strong communication and interpersonal skills.
- Excellent organizational and record-keeping abilities.
- Ability to multitask and work under pressure.
- Strong attention to detail and problem-solving skills.
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