Care Manager (Western Region) - FAK

Job Summary

• To perform all the case management roles both at the contact Centre and  back office, which includes but not limited to:

Job Description

• Professionally respond to calls in relation to call Centre guidelines and provide solutions to customer
• Respond to all emails and give feedback within one 30 minutes of receiving them. 
• Critically analyze all pre-authorization and give accurate response within one hour in line with policy benefits.
• To handle All the optical/Dental related case in addition to other assigned roles.
• To vet all prescriptions and other bills to identify any overpriced items.
• Negotiate with service providers for sustainable costs containment measures.
• Mitigate fraud through daily bill vetting and regular hospitals Visitation of admitted patients in various hospitals.
• Discharge patients within 30 minutes, outpatient email response within 15 minutes. 
• Daily sending of admissions reports to clients; Brokers/Agents/ company Human resource managers. 

Relevant Experience & Qualification

• Bachelor’s degree in nursing or other related medical field
• Minimum four (4) years' experience in a similar role in the insurance industry
• Insurance Professional qualification

Education

• Further Education and Training Certificate (FETC): Business, Commerce and Management Studies (Required)