Total Health Trust Limited – Our organization is a leading and largest health maintenance organization (“HMO”) in Nigeria with over 270,000 members and over 270 private corporations representing some of the country’s top local and international multinationals, as well as public sector institutions under our management. We were the first HMO to be registered in Nigeria and 17 years later, we are still number one in the market. We are one of the very few HMOs that can boast the financial and technical backing of a world class company – Liberty Health (a member of the Liberty Group). The organization further prides itself with its rich culture of Respect, Compassion, Pride and Expertise.
CALL CENTRE AGENT
JOB DESCRIPTION:
1 Receive calls from members or employer groups and providers and prospective clients
2 To receive calls from providers and have first call resolution on pre-authorization queries for limited and straight forward cases or route the query to the correct department for call resolution
3 To receive Employer group calls and to resolve queries relating to the specific group or members within the group and route the query to the correct department for call resolution in the more complex cases
4 To receive and resolve all member related calls and to ensure that all complaints and queries are resolved on first call resolution or escalate the query for resolution
5 To receive calls from prospective clients and re-route the calls to the Sales and Distribution department ensuring that het prospective clients receive the best service
6 To log enquiries for all calls relating to registered providers, Clients and members
7 To follow up on specific cases as distributed by the manager to ensure a value added service offering
8 To adhere to and live the organizational values
REQUIREMENTS:
• Candidate must be a registered nurse, midwife and possess B.Sc. Nursing
• Additional medical qualification will be an added advantage
• Candidate must have minimum of 3 years medical experience including 2 years in similar role in a Health Maintenance Organization (HMO)
• Candidate must have Clinical or General Nursing and Insurance Call Centre experience
• Candidate must have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes, and Scheme Rules.
• Excellent organizational, communication (verbal and written), listening skills and attention to detail.
• Candidate must be very proficient in Microsoft office packages
OTHER REQUIREMENTS:
• Good organizational and planning capabilities
• Innovative and quick thinking capabilities
• Innovativeness
• Adaptive
• Decision Making skills
• Integrity
• Ability to work under pressure
• Adaptive, expertise, Result-Oriented, Relationship Skill
• Working with people
• Strategic
• Must be a good collaborator/Team player
CLAIMS ASSESSOR
JOB DESCRIPTION:
• To vet all claims pertaining to either the managed care or Blue product to ensure that the daily targets are achieved
• To capture all claims pertaining to either the managed care or Blue products to ensure that the daily targets are achieved
• Send out cheques to providers within the agreed SLA
• To ensure all Claims correspondence to providers or members are sent out timeously
• To adhere to and live the organisational values.
REQUIREMENTS:
• Candidate must be a registered nurse, midwife and possess B.Sc. Nursing
• Additional medical qualification will be an added advantage
• Candidate must have minimum of 4 years post-nursing qualification experience including 2 years in similar role in a Health Maintenance Organization (HMO).
• Candidate must have Clinical experience
• Candidate must have advanced knowledge of NHIS regulatory guidelines, Medical Global Best Practices, Health Insurance, Products and Processes, Claims Processes and Procedures and Scheme Rules.
• Excellent organizational, communication (verbal and written) skills and attention to detail
OTHER REQUIREMENTS:
• Good organizational and planning capabilities
• Innovative and quick thinking capabilities
• Innovativeness
• Adaptive
• Decision Making skills
• Integrity
• Negotiation Skill
• Adaptive, expertise, Result-Oriented, Relationship Skill
• Working with people
• Strategic
• Must be a good collaborator/Team player
TO APPLY
Click on Job Title below:
Jobs at Total Health Trust Limited, Friday 12, February 2016
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