HMO Officer at St. Dominic Catholic Hospital – Ibadan

St. Dominic Catholic Hospital is recruiting an HMO Officer in Ibadan, Oyo State. The position will manage HMO patient enrolment, authorisations, claims and payment reconciliation.

Key responsibilities

• Check HMO coverage and patient eligibility and secure the relevant authorisation codes.
• Help insured patients understand covered services, co-payments and exclusions.
• Liaise with clinicians on treatments, admissions, referrals and required pre-authorisations.
• Prepare complete claims, follow up with HMOs and reconcile payments and deductions with finance.
• Maintain working relationships with insurance partners and observe NHIA guidelines and tariff agreements.
• Attend HMO meetings and audits, communicate policy changes and maintain accurate records.
• Prepare regular reports on patient volume, revenue, outstanding claims and operational challenges.

Qualifications and requirements

• HND or bachelor’s degree in Health Administration, Finance, Nursing, Public Health or a related field.
• One to five years in an HMO, hospital corporate-services or insurance environment.
• Understanding of NHIA guidelines, HMO operations, hospital billing and claims.
• Good Excel, Word and HMO portal skills.
• Accurate records, strong interpersonal skills, discretion, negotiation and problem-solving ability.