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HCP Relationship Officer – Assistant at Life Quest Technologies Ltd

  • Full Time
  • Lusaka
  • 00 USD / Year
  • Applications have closed
  • Salary: 00

Life Quest Technologies Ltd

Essential Duties-

  • Plan Hospital Risk and case management visit to familiarize Case Managers with the patient’s condition to be able to do the relevant interventions
  • Carry and manage Company emergence line 24X 7. Ensure that Life Quest Tech receives the pre-auth from hospitals
  • Accounts reconciliation of claims settlement of all eligible medical claims within agreed service level agreements (SLA) with the network health care providers and Insurers
  • To ensure that Health Care Providers are informed in time of the incomplete and hold claims, to avoid unnecessary disputes and disruptions in services due to non-payment of claims
  • Responsible for managing relationships and monthly billing reconciliations between the accounts dept and various Insurance Companies/ Healthcare Providers to ensure that claim are settled within SLA; send claim settlement advice to the health care providers within 48 hours of receiving confirmation of transfer and sign off on monthly billing basis
  • Reconcile of all payments with health care providers within 60 days of receiving settlement transfer advice; health care providers are required to re-submit suspended claims requiring additional/missing information within 30 days of advice and you will be required to ensure that this is adhered to as per SLA

General Duties-

  • Ensure that the providers adhere to the Insurer policy cover during the member’s hospitalizations
  • Liaise with the network providers to ensure a seamless admission and discharge process of members
  • Ensure the member bill are collected from their respective hospital
  • Vet all bills as per policy biding the medical scheme at hand
  • Be able to submit reports as per SLA of respective clients
  • Continuous training and maintaining good relationships with HCP partners
  • Maintain patient data & Confidentiality as per Life Quest Tech policy