Total Health Trust Limited a leading Health Maintenance Organization (HMO) is recruiting to fill the position below:
POSITION : Branch Agent (Medical)
Responsibilities
Facilitate the investigation of potential fraudulent claims within the specific branch and provide feedback to the Branch manager
Hospital visits regarding specific branch cases
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
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
Following Head Office approval, to ensure a successful provider forum is held as stipulated
Ensure provider education is done and ensure product knowledge and processes are understood towards seamless service delivery to enrollees
Decision Making skill and Excellent Customer Service Skill
Integrity
Sorry the application deadline for this job has elapsed
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