You will be responsible for providing excellent client services to a portfolio of clients of SIMEKA HEALTH by efficiently managing human capital queries, provide advice when required, claims and queries and all other medical scheme, gap cover, primary health insurance, loyalty related queries.
This role will be based in Sandton, Johannesburg.
Key Responsibilities
- Provide an effective and efficient administrative channel between clients and service providers
- Must demonstrate a good understanding of all medical scheme options and benefits, primary care insurance, gap cover and loyalty programs
- Must provide, multiple query resolutions, ability to communicate in both written and a verbal professional manner
- Manage escalated admin and other requirements from service providers for clients
- Assists the Centralised Service Centre with in-bound and out-bound client calls
- Provide timeous feedback and resolution
- Assist clients with the application process, requirements and queries telephonically and / or via e-mail up to resolution. Frequent follow up with clients
- Assisting with new and existing quotes and advice where required
Keep ongoing records on internal CRM systems
Qualification and Experience
MatricIndustry related Degree or Diploma (NQF level 5) is requiredRegulatory Examination RE5 is required2 - 3 years' experience in a similar healthcare environment is requiredFull accreditation with the Council for Medical Schemes is advantageousFinancial services industry experience would be advantageousKnowledge and Skills
Knowledge of industry regulations e.g., POPI and TCFExperience in managing customer relationshipsExperience in handling customer complaintsStrong knowledge of medical scheme product and processesStrong knowledge of Internal and external processes including service level commitmentsKnowledge of relevant escalation channelsKnowledge in managing and co-ordinating escalations from HR and other stakeholdersExperience in managing customer relationshipsProficiency in Microsoft Office (Word, Excel, Outlook)Proficient in both English and Afrikaans (verbal and written)Core Competencies
Cultivates Innovation by creating new and better ways for the organisation to be successfulClient Focus - Building strong customer relationships and delivering customer-centric solutionsDrives Results - Consistently achieving results, even under tough circumstancesCollaborates - Building partnerships and working collaboratively with others to meet shared objectivesResilience - Rebounding from setbacks and adversity when facing difficult situations.Communicates effectively - Contributing independentlyDecision quality - Contributing independentlyAction orientated - Contributing independentlyOptimises work processes - Contributing independently#J-18808-Ljbffr