HMO Desk Officer

About the role

The HMO Desk Officer will serve as the primary point of contact for patients enrolled in health maintenance organizations, ensuring smooth verification, authorization, and documentation processes. This role supports clinical teams by managing HMO interactions and maintaining compliance with insurance guidelines.

Key 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.

Required profile

• 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 (advantageous).
• Strong communication, interpersonal, and organizational abilities.
• Ability to multitask, work under pressure, and pay close attention to detail.

Required skills

• Proficiency in Microsoft Word.
• Proficiency in Microsoft Excel.
• Proficiency in Microsoft Outlook.