Call Center Nurse at Prepaid Medicare Services Limited

Summary

• To answer and or/initiate customer calls, respond to customer needs in a professional, service-oriented manner and maintain the highest level of customer satisfaction by seeking first call resolution. Modelling effective communication skills, call centre agents must be knowledgeable about the products and services of Prepaid Medicare Services Ltd HMO.

Key Responsibilities

Include the following. Other duties may be assigned:

• Function as an information source through telephonic assistance to members, providers, billing agencies, and various company/department staff.
• Provide pleasant customer experience through superior customer service methods, problem-solving and real-time issue resolution.
• Interact with the provider community and various departments to resolve issues involving the membership and credentialing status.
• Explain benefits, eligibility status, enrolment processing procedures and status of authorizations and referrals to callers.
• Conduct member outreach calls as assigned to proactively educate members on services available (Welcome Calls).
• Process complaints, following established guidelines.
• Maintain knowledge of National guidelines, regulations, and departmental policies and practices and maintain accurate documentation for compliance.
• Answer calls professionally and respond to customer inquiries
• Identify and escalate priority issues

Required Skills
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and/or ability required.

• Computer literate
• Attention to detail
• Professional development through participation in continuing education and professional Organizations.
• Good verbal and written communication skills
• Must be Conversant with the HMO processes and Maintenance
• Must also be good in Coordination, Listening, Scheduling and Teamwork
• Must possess good administrative skills
• Superior problem solving skills
• Ability to explain detailed instructions articulately and clearly
• Ability to analyse Information promptly
• Exceptional customer services skills
• Proficient in relevant computer applications
• Knowledge of customer service principles and practices
• Knowledge of call centre telephony and technology
• Relevant product knowledge

Requirements

• Must be a certified Registered Nurse with 3 to 5 years clinical experience
• Must be willing to resume work minimum 3 days after interview.
• Must be willing to work 24 hours
• Knowledge of the operations of the National Health Insurance Authority (NHIA) and Health Maintenance Organization will be an added advantage
• Excellent customer relation skills
• Good communication/presentation skills (both oral and written)
• Ability to communicate effectively in both oral and written English language
• Must be a team player, able to build and maintain effective and collaborative sales and marketing network
• Must be able to take responsibility and demonstrate high level of integrity in dealing with all stakeholders