About this role
The role is for an HMO Officer at St. Dominic Catholic Hospital in Ibadan, Oyo. The HMO Officer manages all Health Maintenance Organization operations within the hospital, including enrollment, authorization, claims processing, and liaison with HMOs and patients to support service delivery and revenue collection. The hospital offers general medical and allied services and collaborates with foreign partners; it is NHIS accredited and Licensed. The position is full-time and focused on ensuring HMO processes align with package guidelines and hospital policies. The (primary) aim is to maintain efficient HMO relations, compliance, and accurate documentation.
What you would do
- Coordinate patient eligibility verification with HMO portals before care
- Register enrollees and issue authorization codes for HMO patients
- Prepare, submit and follow up on HMO claims with supporting documents
- Obtain pre-authorization for consultations, admissions, surgeries, and referrals
- Track HMO payments, reconcile with hospital finance, and pursue outstanding claims
- Communicate policy changes and tariff updates to clinical staff
- Represent the hospital at HMO meetings, trainings, and audits
- Ensure compliance with NHIA/HMO guidelines and service level agreements
- Maintain an up-to-date database of HMO patients, authorizations, and claims
- Prepare weekly/monthly reports on HMO activity and revenue and document filing for audits
What they are asking for
- 1-5 years of experience in an HMO, hospital corporate services or insurance department
- HND or Bachelor's degree in Health Administration, Finance, Nursing, Public Health or related fields
- Knowledge of NHIA guidelines, HMO operations, and hospital billing processes
- Strong negotiation and problem-solving skills
- Ability to work under pressure and meet deadlines
- Excellent communication and interpersonal skills
- Proficiency in Microsoft Excel, Word and HMO portals
- Professional and patient-centred approach
- Attention to detail and good record-keeping
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