HMO Claims and Billing Officer Job at Equity Specialist Hospital

• We are currently seeking a detail-oriented and proactive HMO Claims and Reconciliation Officer to join our growing healthcare team.
• The ideal candidate will be responsible for managing all Health Maintenance Organization (HMO) claims, ensuring accurate billing, timely submission, and proper reconciliation of payments in line with service agreements and healthcare regulations.

• Prepare and submit accurate HMO claims in a timely manner.
• Follow up on submitted claims and resolve discrepancies or rejections.
• Liaise with HMO representatives to ensure prompt resolution of issues.
• Reconcile payments received with submitted claims and update records accordingly.
• Generate periodic reports on claims status and outstanding payments.
• Maintain up-to-date knowledge of HMO policies and billing guidelines.
• Collaborate with clinical and finance teams to ensure accurate documentation and billing processes.

• Minimum of OND / HND / B.Sc in Accounting, Finance, Business Administration or related field.
• 2+ years of experience in HMO claims processing and reconciliation (preferably in a healthcare or hospital setting).
• Strong knowledge of HMO processes and healthcare billing standards.

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