About the Job:
Starcare International Hospital is looking for a meticulous and experienced HMO / Billing Officer to manage patient billing, insurance claims, and health maintenance organization (HMO) relations. The ideal candidate will ensure accurate invoicing, prompt claims processing, and smooth interaction between the hospital, patients, and insurance providers. This role is key to ensuring revenue flow, customer satisfaction, and compliance with healthcare financial practices.
Key Responsibilities:
HMO Coordination & Claims Management:
Verify patient coverage and eligibility with HMOs, insurance firms, and corporate health partners.
Manage pre-authorizations, treatment approvals, and follow-up for payments.
Submit claims promptly and ensure correct coding and documentation as per insurer requirements.
Resolve claim rejections, discrepancies, and pending issues with HMO desks.
Billing & Invoicing:
Generate accurate bills for services rendered using the hospital’s billing system.
Monitor payments, co-payments, deductibles, and out-of-pocket expenses.
Reconcile daily, weekly, and monthly billing reports with finance and accounts.
Liaise with front desk and finance teams for proper billing documentation.
Customer Service & Record-Keeping:
Address patient inquiries regarding bills and insurance matters professionally.
Maintain updated records of HMO tariffs, policies, and agreements.
Support audit readiness with well-documented and traceable billing files.
Skills & Experience Required:
Essential:
Bachelor’s degree or HND in Accounting, Finance, Business Administration, or Health Information Management.
Minimum of 3 years of hands-on experience in billing and HMO management in a hospital setting.
Good understanding of health insurance processes, coding standards, and medical billing systems.
Strong attention to detail, analytical skills, and proficiency in Microsoft Excel.
Excellent communication and interpersonal skills.
Desirable:
Familiarity with hospital billing software or EMR (Electronic Medical Records) systems.
Existing network or prior liaison experience with major HMOs and insurance companies in Nigeria.
Knowledge of NHIS (National Health Insurance Scheme) processes and updates.
Apply Now
Join a team that believes in patient-first care, celebrates teamwork, and strives to shine brighter together.