HMO / Billing Officer at JoyBridge HR Solutions

JoyBridge HR Solutions - Our client is recruiting suitably qualified candidates to fill the position below:

Job Title: HMO / Billing Officer

Location: Magodo Phase 2, Lagos
Employment Type: Full-time

Job Brief

• Our client is looking for a HMO/Billing Officer who will be responsible for managing all activities related to Health Maintenance Organizations (HMOs), private billing, and corporate account transactions.
• The officer ensures timely and accurate billing, claims processing, payment reconciliation, and efficient communication with HMOs and corporate partners to optimize revenue collection and ensure service payment compliance.

Key Responsibilities
HMO & Insurance Management:

• Register and verify patient HMO eligibility and benefits before service delivery.
• Liaise with HMO representatives for approvals, service codes, and pre-authorizations.
• Track, document, and manage all HMO-related treatments, investigations, and referrals.
• Ensure that all HMO claims are submitted accurately and on time.

Billing Operations:

• Prepare and issue invoices for HMO, private, and corporate clients.
• Accurately capture all billable services and consumables used by patients.
• Monitor and reconcile daily patient bills and revenue against services rendered.
• Identify and correct billing discrepancies before submission.

Claims Management:

• Compile, validate, and submit claims to HMOs and corporate clients promptly.
• Track the status of submitted claims and follow up on pending or rejected ones.
• Resubmit or rectify rejected claims with supporting documentation.
• Maintain proper documentation for all claims for audit and review purposes.

Payment Reconciliation:

• Reconcile payments received with claims submitted to ensure completeness and accuracy.
• Work closely with the finance team to ensure timely posting of payments and resolution of variances.
• Prepare periodic aging reports and outstanding claims summaries for management.

Reporting & Documentation:

• Maintain accurate records of patient accounts, invoices, HMO approvals, and payment remittances.
• Generate daily, weekly, and monthly billing and payment reports.
• Flag issues of non-payment or delayed remittances to the appropriate authority.
• Support audits by providing relevant billing documentation and reconciliations.

Relationship Management:

• Serve as the point of contact for all HMO-related inquiries and correspondence.
• Foster strong professional relationships with HMO and corporate account officers.
• Address complaints or issues from patients and clients related to billing.

Qualifications & Requirements

• Bachelor's Degree or HND in Accounting, Finance, Business Administration, or related fields.
• 1-2 years minimum experience in HMO/Billing Officer role.
• Knowledge of HMO operations, health insurance codes, and billing procedures.
• Excellent proficiency in Microsoft Excel and EMR platforms.
• Strong attention to detail and ability to multitask.
• Good communication and interpersonal skills.
• Must be ready to resume immediately.

Application Closing Date
31st August, 2025.