HMO Officer (Ilupeju) needed at Greenlife Pharmaceutical Limited

Responsibilities

• Registering of new HMO and liaising between these HMOs and the company.
• Ensuring all HMO issues are resolved promptly.
• Working on and ensuring we get the best possible tariffs from HMOs we are partnering with.
• Acting as intermediary between our clients and our HMO partners
• Getting of approval codes for eligible patient by filling in the requested services on the HMO portal
• Communicating to HMOs by writing through email for approval and 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, etc
• Processing of HMO claims.
• Excellent communication skills with an ability to think creatively and innovatively.
• Sending of bills estimate for procedures to HMO and obtaining proper approvals.
• Ensuring that all the services given are paid for.
• Following up with front desk to find out services that approvals were omitted and sorting out payment with the HMO
• Following up on patients to pay for services that the insurance declined payment for.
• Ensuring that doctors document diagnosis appropriately on their request to reduce claims denial.