HMO Hospital In-Patient Officer

Job Description

• Ensure the proper monitoring of confinements of iCare members in accredited medical facilities.
• Ensure that members’ queries, concerns and/or complaints are attended to in a timely and appropriate manner prior to elevating this to the HLO Head.
• Keep abreast with current regulations and policies affecting medical services and implementation and provide proper guidance to all concerned.
• Be up to date on medical updates, utilization management, newly onboarded and renewed account benefits.
• Maintain company spiels and lines that will entice members to approach him/her regarding their benefit including medical network inquiries, concerns and LOA issuances.
• Visit admitted members ensuring to discuss the member’s coverage and benefits and issue the letter of authorization (LOA).
• Monitor daily the member’s progress chart to know member’s needs and current medical condition.
• Assist the member duri...