JOB TITLE: Quality Assurance Officer
JOB LOCATION: Abuja (FCT)
JOB DETAILS:
The Role
- Vetting all HMO invoices for proper diagnosis, treatment and services.
- Routine reconciliation of outstanding bills with corporate organizations under Health Maintenance Organization (HMO) contractual agreement.
- Managing chronic disease register.
- Liaising with clinicians on care for HMO and corporate patients
- Liaising with HMO and corporate organizations on patient care
Responsibilities
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- Effective monitoring to ensure that HMO’s patients access care that are within their insurance coverage.
- Ensuring that treatments and patients’ case notes are properly documented.
- Monthly and yearly reconciliation of outstanding bills with corporate organizations.
- Examine patients’ case notes to verify the treatments that they are able to access.
- Explain benefits, eligibility status, enrollment processing procedures and status of authorizations and referrals to patients/clients/corporate organizations.
- Ensure and maintain accurate documentations for all HMO patients/clients.
- Respond to all HMO patients’/clients’ inquiries and handle complaints accordingly.
- Interface with corporate organizations via correspondences, emails and physical negotiations.
Qualifications
- MBBS
- 2+ years proven work experience as a HMO medical officer or similar role
- Familiarity with office machines (e.g. fax, printer etc.)
- Knowledge of administrative procedures
- Proficient in English (oral and written)
- Excellent knowledge of MS Office (especially Excel and Word)
- Strong communication and people skills
- Good organizational and multi-tasking abilities
- Problem-solving skills
- Customer service orientation.
Special Conditions
- Employment is contingent on passing a medical screening conducted by the hospital
- The employee will be subject to various testing including but not limited to drug and medical testing throughout the tenure of their employment.
HOW TO APPLY
Interested and qualified candidates should send their CV and Cover Letter to: [email protected] using the Job Title as the subject of the email.
Deadline: July 5, 2021
Job Features
Job Category | officer |