Call Centre Officer
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Job summary
We are seeking an experienced Call Centre Officer to manage enrollee enquiries, complaints, healthcare access and pre-authorisation requests. The role involves assessing requests, issuing appropriate pre-authorisation codes, coordinating with providers, providing clinical guidance within scope, and ensuring timely resolution of cases.
Min Qualification:
Diploma
Experience Level:
Entry level
Experience Length:
2 years
Language Requirement:
English
Working Hours:
Contract - Rotating Schedule
Applicant Location:
Abuja, Nigeria
Job descriptions & requirements
Responsibilities:
- Receive and respond to enrollee and healthcare provider calls.
- Review and process requests for pre-authorisation in line with approved HMO policies and benefit plans.
- Issue pre-authorisation codes for approved services.
- Verify enrollee eligibility and benefit entitlement before authorisation.
- Liaise with healthcare providers regarding treatment requests and required documentation.
- Escalate cases requiring medical review or higher-level approval.
- Handle complaints relating to access to care, authorisation and provider services.
- Document calls, authorisations, complaints and resolutions accurately.
- Follow up on pending authorisation requests and outstanding cases.
- Maintain confidentiality of enrollee and medical information.
Requirements:
- Degree
- 2 years experience
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