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• To attend to calls from healthcare providers and handle first call resolution on pre-authorization queries for limited and straight forward cases and or route queries to the appropriate departments for inquiries resolution.
• To attend to calls and resolve queries relating to the specific group or members within the group and or route the query to the appropriate department for professional and prompt resolution in the more complex cases.
• To attend to and resolve all enrollees inquiries and ensure that all complaints and queries are promptly resolved on first call resolution and or immediately escalate the query for resolution.
• To attend to calls from prospective clients and re-route the calls to the marketing department ensuring that the prospective clients receive the best information or clarifications, to make an informed decision.
• To meticulously log all inquiries for management analysis and documentation for all relevant stakeholders.
• To follow up on specific cases as assigned by the line manager for measurable outcomes and stakeholders satisfaction.
• To perform all other responsibilities that would always enhance the corporate image of the organization.
• Candidate must be a registered nurse, midwife or possess B.Sc. in Nursing.
• Additional medical training qualification will be an added advantage.
• Candidate must have a minimum of 3 years medical experience out of which 2 years must be in similar role in a Health Maintenance Organization (HMO) or Healthcare facility.
• Candidate must have Clinical or General Nursing and Health Insurance Call Centre experience.
• Candidate must have a fair knowledge of NHIS operational guidelines, Clinical Best Practices and Health Insurance operational models.
• Excellent emotional intelligence, good and effective verbal and written communication prowess with ability to decode messages and work with little supervision.
• Candidate must be very proficient in Microsoft office packages.
• Candidate must be a good team player.
• Candidate must be very flexible and innovative.