Hiring Organization: Total Health Trust Ltd
Job Description
To manage specific cases in the branch / zone in order to get the best outcome
To facilitate the process of pre-authorisations and authorisations between the provider and the scheme and to give feedback to the relevant party concerned
To facilitate resolution of all queries from providers and members within the branch/zone on specific cases and within the agreed SLA
To facilitate the investigation of potential fraudulent claims within the specific branch / zone and provide feedback to the Branch manager
Hospital visits regarding specific branch / zonal cases
To provide services in the accreditation and re-accreditation of branch/zonal providers to ensure that provider facilities and services are up to standard as per the agreed standards using a standardized checklist.
To adhere to and live the organizational values.
Qualifications
Applicant must be a Registered Nurse
Applicant must have 5-8 years experience
Must have knowledge of NHIS
HMO Experience is an added advantage
Other Requirements:
Good communication skills
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
How to Apply
Interested and qualified? Go to Total Health Trust Ltd on jobs.smartrecruiters.com to apply