Vacancy HMO Claims Officer needed

HMO OFFICER
October 16, 2024
Application deadline closed.

Job Description

HMO Claims Officer
Overview:

Seeking a detail-oriented HMO Claims Officer to manage HMO claims processing and reimbursement for medication orders. This role involves ensuring timely and accurate claims submission and resolving related issues.

Responsibilities:

1. HMO Claims Processing:
Input and submit claims accurately.
Monitor and track claims status.

2. Eligibility Verification:
Verify patient eligibility and benefits.
Obtain PA authorization codes as needed.

3. HMO Claims Resolution:
Investigate and resolve claim rejections.
Communicate with HMO companies, providers, and patients.

4. Payment Reconciliation:
Reconcile payments with submitted claims.
Address discrepancies and maintain financial records.

5. Support and Education:
Assist clients and patients with claims and reimbursement queries.
Educate on the claims process and insurance benefits.

6. Record Maintenance:
Maintain accurate records of claims, payments, and communications.

Skills:

1. Proficiency in claims software and Electronic Health Records systems.
2. Familiarity with insurance billing codes and medical terminology.
3.Strong analytical, communication, and organizational skills.
4. High attention to detail and customer service orientation.

Educational Qualification:
A minimum of a Bachelor’s Degree in any related field.

Salary for this role is #150,000.
HMO, and other benefits.

Experience:
At least 1year experience in HMO claims processing.

Application deadline – 30th October , 2024.

https://docs.google.com/forms/d/e/1FAIpQLScZKggAD5_wjOSxhtE-MV34x6YSjABFbbpHHPvx8uzy2aSoDg/viewform