Oceanic Health Management Limited is one of the largest Healthcare insurance providers in Nigeria offering optimum services that is second to none in the healthcare industry. Our friendly environment and smart use of technology has enabled us offer excellent HMO services to our clients who are spread across multiple industries in Nigeria.
We are recruiting to fill the position below:
Job Title: Call Centre Executive
Location: Lagos
Employment Type: Full-time
Job Duties / Responsibilities / Accountabilities
- Receive calls from OHML Clients, Providers and Staff
- Receives calls from OHML enrollees and prospects
- Manages Call Centre correspondence.
- Responds to clients within approved timeline
- Responds appropriately to situations in accordance with standard care metrics
- Give pre-authorization to care
- Send daily authorization report to regional managers and medical managers
- Understand the use of IT application for customer care correspondence (CC Metrics)
- Use the CC Metrics optimally
- Escalates for update of provider directory and hospital details when received from providers
- Escalates information received to appropriate office at OHML
- Escalates complaint received to appropriate office at OHML
- Sends capitation list to providers monthly
- Calls providers to ascertain receipt of the list of enrollees
- Calls providers whenever assigned by the HOD for various communiques
- Ensure zero denial of care when informed of access request at provider facility
- Authorizes care at provider facility
- Handles referral on provider or enrollee request
- Emergency handling protocol and escalation
- Inform call-in OR e-mail clients of OHML plans
- Educate requesting call-in clients on OHML products
- Manages complaints at first contact and give feedback within stipulated time
- Co-manage care escalated from providers and clients till resolution
- Manages provider grievance emanating from OHML operations
- Coordinates the central pre-authorization system
- Coordinates the use and mastery of call center applications
- Organizes the Call Centre for optimal efficiency
- Ensure 24 / 7 coverage and zero shut down of the call centre operations
- Improve turn-around time for pre-authorization issuance
- Provision of PA report to relevant offices on a regular basis
- Submission of weekly CC Metrics report to Head of Medical Operations
- Submit Incident report weekly to Head of Medical Operations
- Any other task as assigned by HOD
Qualifications
- B.Sc / BA in related field.
- Minimum of 2 - 3 years experience in call center with HMO organizations is essential.
- Excellent verbal and written communication skills
- Customer Care
- Nursing background is a plus.
Application Closing Date
15th May, 2024.
How to Apply
Interested and qualified candidates should send their CV to: recruitment@oceanichealthng.com using the job title as the subject of the mail.
