HMO / NHIS Officer at St Dominic Catholic Hospital

Job Overview

Location
Lagos, Oyo
Job Type
Full Time
Date Posted
8 days ago

Additional Details

Job ID
129419
Job Views
29

Job Description






Job Summary




  • The Health Insurance Officer is responsible for managing all health insurance related activities within the hospital, including claim verification, processing, and payment reconciliation.

  • They act as a key liaison between the hospital, insurance providers, and patients, ensuring accurate and timely billing and payment for services rendered.



Key Responsibilities




  • Oversee the entire billing process for health insurance claims, ensuring accurate and timely submission to insurance providers (HMOs).

  • Ensure proper documentation for insurance claims, including medical coding, billing codes, and patient information.

  • Resolve any discrepancies or issues with rejected claims, working closely with insurance companies and healthcare



Compliance & Documentation:




  • Maintain accurate records of all billing transactions, claims, and payments.

  • Stay updated on changes in healthcare insurance Policies.



Customer Service & Dispute Resolution:




  • Handle inquiries from insurance companies, patients, and other stakeholders regarding billing issues, claims status, and payments.

  • Work closely with the patient services department to resolve any billing-related concerns, ensuring a positive patient experience.

  • Resolve billing disputes and follow up on unpaid claims to ensure timely and accurate payments.

  • Prepare and process medical expressions and related documents.

  • Maintain accurate insurance records and ensure timely follow-ups.

  • Collaborate with departments and liaise with insurance companies effectively.



Requirements




  • Minimum of 2 years of relevant experience.

  • Proficiency in MS Office Suite (Word, Excel, PowerPoint).

  • Excellent communication, attention to detail, and organizational skills.



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