Graduate Jobs at Total Health Trust Limited (THT)

Job Description:

• Receive calls from members or employer groups, providers and prospective clients
• 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
• 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
• 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
• 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
• To log enquiries for all calls relating to registered providers, Clients and members
• To follow up on specific cases as distributed by the manager to ensure a value added service offering
• To adhere to and live the organizational values

Requirements:

• Candidate must be a registered nurse, midwife or possess B.Sc. Nursing with valid license.
• Candidate must have a minimum of Credit or Second Class Upper Division and additional medical qualification will be an added advantage
• Candidate must have minimum of 1 year clinical experience and experience in similar role in a Health Maintenance Organization (HMO) will be an added advantage
• 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
• Must be a good collaborator/Team player

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Location: Benin Office, Edo State.

Job Description:

1. To manage specific cases in the branch in order to get the best  outcome
2. To facilitate the process of pre-authorisations and authorisations between the provider and the scheme and to give feedback to the relevant party concerned
3. To facilitate resolution of all queries from providers and members within the branch on specific cases and within the agreed SLA
4. To facilitate the investigation of potential fraudulent claims within the specific branch and provide feedback to the Branch manager
5. Hospital visits regarding specific branch cases
6. To provide services in the accreditation and re-accreditation of branch providers to ensure that provider facilities and services are up to standard as per the agreed standards using a standardized checklist
7. To adhere to and live the organizational values
8. Following Head Office approval, to ensure a successful provider forum is held as stipulated
9. To ensure provider education is done and ensure product knowledge and processes are understood towards seamless service delivery to enrollees

Requirements:

• Candidate must be a registered nurse and midwife
• B.Sc. Nursing and 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 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 skill and Excellent Customer Service Skill
• Integrity
• Ability to work under pressure
• Adaptive, expertise, Result-Oriented, Relationship Skill
• Working with people
• Interpersonal Skill
• Must be a good collaborator/Team player