HMO / Front Desk Officer Job at Odixcity Consulting

• Our client is looking for a Hmo/ Front desk officer who will plan and oversee health services, coordination of health workers, manage NHIS/HMO quality initiatives, coordination of meetings and presentations for all departments and units within the hospital and monitor expenses and suggesting cost-effective solutions.
• Work with established teams to develop new health insurance services and concepts, carry out HMO registration and mapping, carry out Hospital registration renewal and accreditation with HMO and relevant government agency, vetting of fee for service bills, and resolve grievances arising in the course of care, the medical/quality assurance reports and other duties that is assigned from time to time by the Chief Medical Director.

• Verification of all Insurance patients that presents to the hospital to access care either by confirming that the patient name is on the list or checking in the patient on the Insurance portal. This has to be done on every patient to avoid denial of payment by insurance.
• Getting of approval code for eligible patients by filling in the requested services on the Insurance portal.
• Communicating to the Insurance by writing through email for approval and or any other required information or care to be given to patients.
• Sending of bills estimate for procedures to Insurances and obtaining proper approvals
• Obtaining medical reports and forwarding them to the various insurance.
• Making sure that all the services given are paid for.
• Authorization must be gotten at every stage of care i.e. for Consultation, investigations, medications, physiotherapy, radiology etc.
• Sending of discharge report by going to inpatient filter from admission date to discharge date and gather all the services that were rendered to the patient and send to the insurance.
• Sending of Insurance daily report on all patients that visited the facility both inpatient and outpatient.
• Following up with billing officers to find out services that approvals were omitted and sorting out payments with the insurance.
• Following up on patients to pay for services that the insurance declined payment for.
• Following up on Doctors to document diagnosis appropriately on their request to reduce claims denials.

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