Contact Centre Doctor / Medical Advisor

To maintain a high and consistent level of service delivery for pre-authorisation requests. To provide medical advisory services to Customers or Providers across all channels of interaction. Ensuring that every Customer encounter with our Customer Service Assistants or Provider network continuously generates positive Customer experience.

Role Qualification:

Academic/Professional:

• MBBS degree from a reputable Tertiary Institution.

Work Experience: Minimum of 3 – 5 years of direct work experience in medical advisory services.

Key Responsibilities:

• Responsible for pre-authorization request administration and management within the Contact Centre team.
• Maintain and develop internal documents to support the Pre-authorization desk within the Contact Center team.
• Review a subset of the pre-authorization requests received across all channels of interaction.
• Assess details of the pre-authorization requests received across all channels based on the internal quality standards (i.e., authorized plan benefits, KPIs and score grid for the sub team).
• Accompany assessment with meaningful, constructive, and thoroughly documented performance feedback.
• Complete special projects as required from time to time.
• Escalate Intensive care and mismanaged cases to the Case Management Team for evaluation or further action.
• Take over critical condition and cases referred by the Pre-authorization desk, educating the patients about their conditions, and providing treatment options.
• Complete special projects as required from time to time.
• Assess details of the pre-authorization requests received across all channels based on the internal quality standards (i.e., authorized plan benefits, KPIs and score grid for the sub team).
• Discuss and explain performance feedback to Customer Service Assistants (Nurses) individually and regularly at monthly meetings.

Required Skills and Competencies

• Ability to take over, handle and follow through on highly sensitive work-related issues via appropriate channel.
• Strong written communication skills and presentation skills.
• Ability to use MS office tools (MS Word, Excel, and PowerPoint).
• Strong Leadership Capability
• Propensity to champion initiatives.
• Goal-Oriented.
• Persuasive.