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.
Decision Making skill and Excellent Customer Service Skill
Integrity
Sorry the application deadline for this job has elapsed
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