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Saturday, September 09, 2017

Branch Medical Agent at Total Health Trust Limited

Total Health Trust Limited (THT), Nigeria’s leading Health Maintenance Organization (HMO) was founded in 1997 and commenced operations in June 1998. Renowned by our stakeholders for our reliability, we have been connecting our members to healthcare providers since 1998. Our unrivalled 18 years industry track record has seen us build a formidable reputation in Nigeria and we remain the HMO
of choice for over 300,000 members and over 500 corporate clients and government institutions.

Position: Branch Agent Medical at Kaduna

Job Description
  • To manage specific cases in the branch 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 on specific cases and within the agreed SLA
  • To facilitate the investigation of potential fraudulent claims within the specific branch and provide feedback to the Branch manager
  • Hospital visits regarding specific branch cases
  • 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
  • To adhere to and live the organizational values
  • Following Head Office approval, to ensure a successful provider forum is held as stipulated
  • 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
  • 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 an 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
  • 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

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