About the Role
The Emel Group, a leading business conglomerate in Nigeria with over four decades of excellence, is seeking a dedicated and detail-oriented HMO Officer to join our dynamic team in Lagos. In this role, you will serve as the primary liaison between our organization and various Health Maintenance Organisations, ensuring that our workforce receives optimal healthcare support and benefits administration.
Key Responsibilities- Manage professional relationships and day-to-day correspondence with Health Maintenance Organisations (HMOs).
- Process HMO authorisations, treatment approvals, and medical claims efficiently.
- Verify patients' HMO eligibility, plan benefits, and coverage limits prior to service delivery.
- Ensure accurate medical documentation and timely submission of all healthcare claims.
- Follow up proactively on outstanding claims, rejected submissions, and payment discrepancies.
- Liaise closely with internal departments and healthcare providers to guarantee smooth service delivery.
- Resolve HMO-related enquiries, concerns, and complaints from employees with high professionalism.
- Maintain secure, comprehensive records of all HMO transactions and patient health information.
- Ensure strict compliance with internal corporate policies and evolving HMO regulatory procedures.
- Bachelor's degree in Nursing, Medical Administration, Health Sciences, Business Administration, or a related field.
- Minimum of 2 to 3 years of proven experience working as an HMO Officer or in medical insurance administration.
- In-depth knowledge of Nigerian healthcare insurance systems, HMO operations, and medical billing procedures.
- Exceptional communication, negotiation, and interpersonal skills.
- Strong analytical abilities with high attention to detail and data accuracy.
- Proficiency in using hospital management software and standard office productivity tools.
- Competitive salary and performance-based incentives.
- Comprehensive health insurance coverage.
- Opportunities for professional growth within a multi-sector conglomerate.
- Dynamic, collaborative, and inclusive work environment at our Lagos headquarters.