Total Health Trust Limited (THT), a Health Maintenance Organization (HMO) is recruiting to fill the position below:
POSITION : Branch Agent
Description
- Provide services in the accreditation and re-accreditation of branch providers to ensure that provider facilities and services are up to standard as per the agreed standards using a standardized checklist
- Adhere to and live the organizational values
- Following Head Office approval, to ensure a successful provider forum is held as stipulated
- Manage specific cases in the branch in order to get the best outcome
- Facilitate the process of pre-authorisations and authorisations between the provider and the scheme and to give feedback to the relevant party concerned
- Facilitate resolution of all queries from providers and members within the branch on specific cases and within the agreed SLA
- Facilitate the investigation of potential fraudulent claims within the specific branch and provide feedback to the Branch manager
- Ensure provider education is done and ensure product knowledge and processes are understood towards seamless service delivery to enrollees
Requirements
- Must be a registered nurse and midwife
- B.Sc. Nursing and additional medical qualification will be an added advantage
- Have minimum of 3 years medical experience including 2 years in similar role in an Health Maintenance Organization (HMO)
- Have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes, and Scheme Rules.
- Organizational, communication (verbal and written), listening skills and attention to detail.
- Very proficient in Microsoft office packages
Others:
- Work under pressure
- Adaptive, expertise, Result-Oriented, Relationship Skill
- Working with people
- Interpersonal Skill
- Team player
- Organizational and planning capabilities
- Quick thinking capabilities
- Adaptive
- Decision Making skill and Excellent Customer Service Skill
- Integrity
Sorry the application deadline for this job has elapsed
