Administration Assistant
Momentum
Total years of experience :4 years, 2 Months
• Enrolment in the HIV program within 2 working days from receipt of application forms as per the Wellness process.
• Enrolment in the Maternity program within 5 working days from receipt of application forms as per the Disease Management process.
• Load IRP follow-ups for the Maternity program according to the Disease Management process and ensure the delivery of the member's maternity gift.
• Record interventions and use correct notes classification.
• Create authorization on approval of scripts by a Case Manager.
• Email authorization letter to provider for all Schemes and SMS to member.
• Contact members who are stopping the scheme to ensure the continuation of care and refer to the case manager as needed.
• Sending blood slips of members to the laboratory for routine pathology tests.
• Loading of blood results on members' profiles, requesting results from pathologists and doctors' rooms as needed
• Call Centre excellence - ensure that telephone and email communication follows HC protocols, policies, KPIs, and SLAs.
• Attending to and resolving e-mail and telephonic queries from providers and members within 2 working days.
• Management of MARS reports as per set admin schedule.
• Handling all types of queries: email, fax, mail, or walk-in members
• Ensure call classifications are entered
• Supplying information on medical aid benefits to members and providers
• Requesting stop payments from finance and re-issuing on payment where necessary
• Correction of paid claims via journals as claims are queried by providers or members after the investigation is complete