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.
- Assist clients with the application process and queries telephonically and/or via e-mail up to resolution.
- Frequent follow up with clients.
Qualification and Experience
- Marketing Degree or Diploma (NQF level 5)
- 2 – 3 years’ experience in a similar healthcare environment is required
- Regulatory Examination RE5 is a requirement
- Full Accreditation with the Council for Medical Schemes is a non-negotiable (no longer under supervision)
Knowledge and Skills
- 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
Behavioural Competencies
- Flexible and Adaptable – Rebounding from setbacks and adversity when facing difficult situations.
- Courage – Stepping up to address difficult issues, saying what needs to be said.
- Ensures Accountability – Holding self and others accountable to meet commitments.
- Plans and Aligns – Planning and prioritising work to meet commitments aligned to organisational goals
Core Competencies
- 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.
Turnaround time
- The shortlisting process will only start once the application due date has been reached.
- The time taken to complete this process will depend on how far you progress and the availability of managers.
Our commitment to transformation
The Sanlam Group is committed to achieving transformation and embraces diversity. This commitment is what drives us to achieve a diverse, inclusive and equitable workplace as we believe that these are key components to ensuring a thriving and sustainable business in South Africa. The Group’s Employment Equity plan and targets will be considered as part of the selection process.
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