HMO Executive

Job Description:

• Act as a liaison between the hospital and Health MaintenanceOrganizations (HMOs), insurance companies, and corporate clients.
• Manage and update contracts with HMOs, ensuring compliance with their policies and procedures.
• Oversee patient billing processes specific to HMO guidelines, including verification of eligibility, authorization for services, and claims processing.
• Address and resolve HMO-related inquiries and disputes from patients and staff, ensuring optimal patient satisfaction and streamlined operations.

Qualifications:

• Bachelor's degree in business administration, healthcare management, or related field.
• Minimum of 2 years' experience in a similar role within a healthcare setting.
• In-depth knowledge of healthcare insurance policies and HMO operations.
• Strong negotiation and problem-solving skills, with the ability to handle sensitive patient information confidentially.
• Excellent communication skills and the ability to work collaboratively with multiple departments.