HMO Billing Officer (Female) at Lagos Executive Cardiovascular Centre

Job Summary

Lagos Executive Cardiovascular Centre seeks a dedicated HMO Billing Officer to coordinate all Health Maintenance Organization (HMO) billing processes. This role ensures accurate claims submission, prompt payment reconciliation, and compliance with health insurance standards. The successful candidate will serve as the primary liaison between the hospital, patients, and HMO representatives, facilitating seamless billing, approvals, and documentation to support financial efficiency and patient satisfaction.

This position requires a detail-oriented, organized, and proactive professional with excellent communication and analytical skills, as well as a solid understanding of medical billing procedures and HMO operations.

Key Responsibilities

HMO Billing & Claims Management

• Prepare, review, and submit HMO bills, pre-authorization forms, and claims in accordance with established guidelines and timelines
• Verify patients' HMO status, coverage limits, and benefits prior to treatment or service
• Ensure proper documentation and coding of services rendered before claim submission
• Monitor all pending and approved HMO claims to ensure timely processing and payment

HMO Liaison & Communication

• Serve as the primary contact person for HMO representatives regarding billing inquiries, approvals, and reconciliations
• Communicate with medical and administrative teams to ensure all procedures and services are appropriately captured for billing
• Follow up regularly with HMO companies for claim approvals and payment updates
• Handle patient inquiries regarding HMO coverage, approvals, and billing procedures courteously and professionally

Reconciliation & Reporting

• Reconcile HMO payments against submitted claims and identify variances, rejections, or shortfalls
• Maintain an up-to-date record of all HMO transactions and outstanding balances
• Generate periodic billing reports for management review and financial planning
• Escalate unresolved issues to senior management as needed