Job Description

As an HMO Liaison Officer for Vision Capital Eye Hospital, your responsibilities are:

• Verification of all Insurance patients and getting of approval code using the insurance portal to confirm patient eligibility and benefits.
• ·         Prepare HMO bills at the end of the month.
• ·         Reconcile HMO bills on the software against what is prepared on the claim form.
• ·         Inspect all HMO bills prepared by the front desk before submission.
• ·         Ensure proper documentation of all HMO Bills submitted.
• ·         Ensure patient diagnosis is properly documented on the hospital’s Electronic Medical Record (EMR) system. 
• ·         Guide the Front desk on HMO tariffs.
• ·         Relate directly with all the HMO public relation Manager to check eligibility status and process complaints following established guidelines.
• ·         Ensure prompt escalation of payment issues to HMO Company and hospital management.
• ·         Ensure all HMO companies pay up as when due.
• ·         Ensure bills and other documentation are properly submitted on the HMO portal.
• ·         Follow up with account officers to find out services that approvals were omitted and sort out payments with the insurance.
• ·         Follow up on patients to pay for services that the insurance declined payment for.
• ·       Follow up with the Optometry and Ophthalmologist to document diagnosis appropriately on their request to reduce claims denials.

Qualification

• ·         Minimum of HND / BSc from a recognised college or institution

  ·         3+ years of experience in a similar role is desirable.  

Reporting Line

You will work closely with the Front Desk Officer, Accounts/Inventory Officer, Insurance Providers, Optometrist, Ophthalmologist and Patients as required. You will report to the Chief Medical Director as needed.

Competency

• ·         Proficient in English (oral and written)

  ·         Strong communication and people skills

  ·         Good telephone and customer service skills

  ·         Good customer relationship and problem-solving skills are required.

  ·         Good coordination, listening, scheduling and teamwork skills

  ·         Knowledge of office administration, basic bookkeeping, and documentation skills

  ·         Knowledge of Microsoft Office applications such as Word, PowerPoint, and Excel

  ·         Good organizational, time management and multi-tasking abilities

  ·         Good computer literacy skills including familiarity with electronic medical records (EMR) and HMO portals.

Working Condition

Full-time on-site work from either of our branches (Magodo, Victoria Island and Ajao)

Office Hours: Weekdays - 9:00 am - 5:00 pm and Saturday - 9:00 am - 3:00 pm

Working environment - This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets

Physical Demand - While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

Key Performance Indicator

• Claims processing efficiency
• Patient feedback and satisfaction
• Authorization turn around time
• Timely communication
• Compliance with clinic's policies and processes 
• Documentation accuracy