HMO

Key responsibilities

• Verify HMO eligibility, benefits, and coverage
• Process LOAs, approvals, and authorization requests
• Coordinate with HMO providers and hospital departments
• Assist patients with HMO requirements and concerns
• Process and monitor HMO claims and supporting documents
• Coordinate billing and coverage-related concerns
• Maintain accurate and confidential HMO records
• Ensure compliance with hospital policies and data privacy requirements

QUALIFICATIONS

• Bachelor's degree in Business, Healthcare Administration, Management, Nursing, or related field
• 1–2 years of HMO, hospital billing, insurance, or healthcare experience preferred
• Knowledge of HMO processing, claims, and hospital billing
• Good communication, organizational, and problem-solving skills
• Detail-oriented, professional, and customer-focused
• Proficient in Microsoft Office/Google Workspace
• Able to work under pressure and maintain confidentiality