Healthcare Provider Relationship Officer – Assistant x4

LifeQuest Technologies Limited is an Insurtech and third-party medical administration Company.

Our services are technology-based enterprise applications mainly for the Health & Life Insurance companies, corporate, government and non-profit donors who use this as license or on Cloud/SAAS basis and includes modules such as reporting, analysis, reinsurance, policy, underwriting, policy administration, claims, mobile apps etc.

Our esteemed clients & partners use our services and enterprise software around the globe to manage sustainable & profitable operations and policy servicing, its technical aspect of insurance product underwriting and claims management.

Our expertise is building capacity to insurers core businesses and growth by helping local insurance companies become profitable and more sustainable.

04 POSITION- HCP RELATIONSHIP OFFICER- ASSISTANT

LOCATION- LUSAKA

REPORTING TO THE MANAGER – CLAIMS CUSTOMER SERVICE & CASE MANAGEMENT

PURPOSE- PROVIDERS ACCOUNT CLAIMS RECONCILIATIONS & RELATIONSHIP MANAGEMENT

Essential Duties-

Manage Company emergence line 24X 7. Ensure that LifeQuest Tech receives the pre-auth from hospitals. Plan hospital case management visits to familiarize Case Managers with the patient’s condition to be able to do the relevant interventions
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 is 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
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
Continuous training and maintaining good relationships with HCP partners
Maintain patient data & Confidentiality as per LifeQuest Tech policy

KEY QUALIFICATIONS:

Diploma in Nursing or at least 2 years’ experience as a Clinical officer in healthcare must
Mandatory Min 2 years working in healthcare background
High level of healthcare business awareness
Understanding of the healthcare business strategies, objectives
Good knowledge of the medical practices, accounting methods
Driver’s license must

PERSONAL ATTRIBUTES:

High standards of honesty and integrity
Self-Starter & Highly Innovative
Resilient and ability to work under pressure
Passion for and attention to detail
Passion for customer/ People care
Good communicator, both orally and written
Team Player & Sense of Urgency
Concern for order and quality
Mandatory knowledge and understanding of computer and a quick learner insurance operating system

QUALITIES & SKILLS REQUIRED UNDERTAKING THE ROLE:

Quantitative/Statistical skills
Relationship Management Skills
Good Interpersonal Skills, Time Management & Negotiation skills
Accounting Skills & Analytical & Planning Skills
Planning and Organization
Computer & Technology savvy

REMUNERATION

No constraints for the right candidate or open for discussion

Note- All applications should be directed along with cv via email to info@lifequestzambia.com Application closing date is 07th April 2025 & Please note that only short-listed candidates for the interviews will be contacted.

LifeQuest Technologies- Medilink International Group is “an equal opportunity employer”, therefore qualified candidates are encouraged to apply irrespective of gender or disability.