Call Center Executive at Oceanic Health Management Limited

About the Role

Oceanic Health Management Limited is expanding its dynamic team and seeking a dedicated Call Center Executive to join our operations in Lagos, Nigeria. This is a critical role responsible for managing client communications, healthcare authorizations, and operational excellence within our call center.

Key Responsibilities

• Receive and respond to calls from OHML clients, providers, staff, enrollees, and prospects within approved timelines
• Manage OHML contact email and call center correspondence
• Process and issue pre-authorizations for healthcare services
• Respond appropriately to situations in accordance with standard care metrics
• Send daily authorization reports to regional managers and medical managers
• Escalate provider directory updates, hospital details, complaints, and information to appropriate OHML departments
• Manage provider grievances and coordinate care escalations from providers and clients until resolution
• Send capitation lists to providers monthly and confirm receipt through follow-up calls
• Facilitate referrals based on provider or enrollee requests
• Handle emergency protocols and escalations appropriately
• Educate clients on OHML plans and products
• Manage complaints at first contact and provide feedback within stipulated timeframes
• Ensure zero denial of care when access requests are made at provider facilities
• Coordinate the central pre-authorization system and submit regular PA reports
• Execute calls to providers as assigned by the Head of Department for various communications
• Ensure 24/7 call center coverage with zero operational shutdown
• Improve turnaround time for pre-authorization issuance
• Submit weekly performance reports and metrics

Required Skills & Competencies

• Proficiency in IT applications for customer care correspondence and CC Metrics
• Ability to use CC Metrics optimally for call center operations
• Knowledge of emergency handling protocols and escalation procedures
• Strong communication and client service skills
• Ability to manage multiple tasks and maintain operational efficiency
• Understanding of healthcare authorization and pre-authorization processes