Call Center Executive at Oceanic Health Management Limited

About the Role

We are seeking a dynamic Call Center Executive to join our expanding team. You will serve as a key point of contact for clients, providers, and staff, managing critical healthcare communications and pre-authorization processes.

Key Responsibilities

• Receive and manage calls from OHML clients, providers, staff, enrollees, and prospects
• Manage OHML contact email and call center correspondence
• Respond to clients within approved timelines and according to standard care metrics
• Issue pre-authorization for care and send daily authorization reports to regional and medical managers
• Utilize IT applications for customer care correspondence, including CC Metrics platform
• Escalate provider directory updates, hospital details, and relevant information to appropriate OHML departments
• Escalate complaints to the appropriate office for resolution
• Send monthly capitation lists to providers and call to confirm receipt
• Contact providers as assigned by the Head of Department for various communications
• Ensure zero denial of care when informed of access requests at provider facilities
• Authorize care at provider facilities and handle referrals on provider or enrollee request
• Manage emergency handling protocols and escalation procedures
• Inform clients of OHML plans and educate them on OHML products
• Manage complaints at first contact and provide feedback within stipulated timeframes
• Co-manage escalated care cases from providers and clients until resolution
• Manage provider grievances related to OHML operations
• Coordinate the central pre-authorization system and call center applications
• Ensure 24/7 call center coverage with zero operational shutdowns
• Improve turnaround time for pre-authorization issuance
• Provide regular pre-authorization reports to relevant offices
• Submit weekly reports and performance metrics

Required Skills & Competencies

• Proficiency with call center applications and IT systems
• Strong communication and customer service skills
• Ability to manage multiple priorities simultaneously
• Knowledge of healthcare operations and pre-authorization processes
• Attention to detail and accuracy in documentation
• Problem-solving and conflict resolution abilities
• Professional demeanor and ability to work in a fast-paced environment

Location

Lagos, Nigeria