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Care Officer – Medical
- Responsible for accurate capture of inpatient undertakings, authorization, cost control and hospital length of stay management.
- Facilitating admissions and discharges of insured members as per policy.
- Conduct hospital visits.
- Manage cost and average length of stay while the patients are in hospital to ensure prudent utilization.
- Pre-authorize treatment for outpatient/inpatient cases as per the policy guidelines.
- Timely respond to all queries from insured client, service providers and respective contact person on cases involving medical care management.
- Maintain a good relationship with partners such as intermediaries at care management level.
- Update the relevant stakeholders on the case management update
- Coordination and facilitation of both road and air evacuation as per policy.
- Seamless Coordinating of overseas treatment from admission to discharge.
- Compile relevant reports within the scope of care management as per stipulated guidelines
- Receive and respond to Medical emergency lines on a 24-hour basis to ensure adequate coverage of the call Centre
- Negotiate for discounts from doctors and service providers on specific cases and procedures as they arise.
Academic and Professional Requirements
- Bachelor’s degree in Nursing or clinical Medicine. E
- Computer literate in MS Office and other office applications E
- Medical Insurance experience in a medical call centre is an added advantage D
- Relevant experience in busy health environment 3