Customer Support and Hospital Liaison Specialist

Outsource Global Technologies Limited seeks a dedicated Customer Support and Hospital Liaison Specialist to support a health insurance client by managing interactions between customers and a network of healthcare providers. The role involves facilitating effective communication, processing claims, approvals, and issuing treatment codes, ensuring seamless operations between the insurer, its customers, and hospital partners.

Key Responsibilities:

1. Customer Support:
Respond to customer inquiries regarding health insurance policies, coverage, and claim processes.
Provide clear, accurate information about policy details, procedures, and benefit options to customers.
Resolve customer issues promptly, with a focus on delivering a positive and efficient experience.

2. Hospital Liaison:
Communicate with healthcare providers to verify claims, confirm eligibility, and approve
treatments and medication in accordance with policy terms.
Issue treatment and medication codes to hospitals and ensure correct processing and
documentation.
Act as the primary point of contact between hospitals and the insurer, facilitating smooth service provision for customers.

3. Code Approval and Issuance:
Accurately process and approve treatment and medication codes per the guidelines provided by the health insurance client.
Maintain a system for tracking issued codes, ensuring timely issuance, and updating relevant parties when necessary.

4. Case Management and Reporting:
Manage individual customer cases, documenting key details of each interaction and maintaining comprehensive case files.
Prepare regular reports on case resolutions, approvals, and any escalations to keep the insurance provider informed of ongoing operations.
Identify and document patterns or recurring issues to enhance service improvement initiatives.

5. Operational Support:
Utilize company-provided tools to log interactions, update case statuses, and manage customer and hospital data securely.
Support the team in implementing best practices, ensuring compliance with company and client policies, and contributing to quality improvements.

Required Qualifications:
Education: Bachelor’s degree in a relevant field (e.g., healthcare administration, insurance, business, or a related discipline).
Experience: Minimum of 2 years experience as a customer support specialist in a Healthcare Organization or Hospital

Skills:
Excellent verbal and written communication skills, with the ability to manage sensitive customer and healthcare provider interactions professionally.
Strong organizational and problem-solving skills, with a keen eye for detail.
Proficiency in customer management systems and familiarity with case-tracking tools.
Ability to work under pressure in a fast-paced environment while maintaining accuracy and empathy.

Preferred Qualifications:
Previous experience in a health insurance or medical claims environment.
Knowledge of health insurance processes, including claims approval, coding, and policy terms.
Bilingual capabilities (Hausa and English) are an added advantage.