The incumbent is responsible for providing excellent client services to a portfolio of clients by efficiently managing human capital queries, any claims and all other medical scheme, gap and medical insurance related queries.
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 with call centre in-bound and out-bound client calls.
- Provide timeous feedback and resolution.
- Keep ongoing records on internal CRM systems.
- Broker Tools experience will be advantageous.
- Assist clients with the application process and queries telephonically and/or via e-mail up to resolution.
- Frequent follow up with clients.
- Regulatory Examination RE5 is a requirement
- Degree or Diploma (NQF level 5)
- Full Accreditation with the Council for Medical Schemes is advantageous
- 2 - 3 years experience in a similar healthcare claims and queries environment is required
- Knowledge of industry regulations e.g., POPI and TCF
- Experience in managing customer relationships
- Experience in handling customer complaints
- Strong knowledge of medical scheme product and processes.
- Strong knowledge of Internal and external processes including service level commitments.
- Knowledge of relevant escalation channels.
- Knowledge in managing and co-ordinating escalations from HR and other stakeholders.
- Experience in managing customer relationships
- Proficiency in Microsoft Office (Word, Excel, Outlook)
- Brokertools experience advantageous
- Cultivates Innovation by creating new and better ways for the organisation to be successful.
- Client Focus - Building strong customer relationships and delivering customer-centric solutions.
- Drives Results - Consistently achieving results and meets deadlines, even under tough circumstances.
- Collaborates - Building partnerships and working collaboratively with others to meet shared objectives.
- Resilience - Rebounding from setbacks and adversity when facing difficult situations.
The Sanlam Group is committed to transformation and embracing diversity and our employment equity plan and targets will be considered as part of the recruitment process. This commitment is what drives us to achieve a diverse workplace with employment equity as a key goal to create an inclusive workforce, representative of the demographics of our society as well as people with disabilities
