Proximity: Ajah-Sangotedo
Qualification Requirements
Candidates should possess a minimum of a Bachelor's Degree, HND, or equivalent qualification in a relevant field. Qualifications in Public Health, Microbiology, Pharmacy Technician, Medical Laboratory Science, or related health sciences disciplines will be considered an added advantage during the selection process.
Key Skills Required:
- Strong communication and listening skills
- Patience and empathy
- Problem-solving ability
- Multitasking and time management
- Basic computer/CRM proficiency
Job Role
- Attend to incoming calls from enrollees, providers, and prospects; make outbound calls when necessary.
- Provide accurate information on HMO plans, benefits, hospital access, and service processes.
- Handle and resolve complaints related to authorization, claims, access to care, or service delays.
- Liaise with hospitals and healthcare providers to confirm enrollee eligibility, approvals, and services.
- Confirm enrollee identity, plan type, and eligibility before providing services or information.
- Assist with pre-authorization requests and guide providers/enrollees on approval processes.
- Help enrollees with issues related to e-cards, login access, and mobile app usage.
- Escalate complex or unresolved issues to the appropriate department Claims, IT, Provider Management.
- Maintain professionalism, confidentiality, and adherence to company policies and healthcare regulations.
