Key Purpose | Provide support with all queries including but not limited to Claims investigations, benefit limits, new business, chronic medication and general queries such as explaining policy, protocol and benefit decisions Identifying and proposing solutions to processes and service related failures. Building and establishing relationships at all levels to facilitate first time resolution of queries |
Key Outputs | Focuses on customer needs through the resolution of queries Scrutinizes numerical data, verbal data and all other sources of information so as to ensure a thorough investigation into queries presented and produces workable solutions to a range of problems. Presenting and communicating information effectively so as to ensure clear understanding and buy-in Establishes good relationships with customers and staff (both internally and externally) to wide and effective networks. Gains clear agreement and commitment from others by persuading, convincing and negotiating. Resolve highly escalated queries swiftly and efficiently Coordinating own and team’s administration Ability to draft written responses of an excellent and consistently professional standard in English, occasionally subject to executive and legal scrutiny |
Competencies | Behavioral Competencies Action orientated Being open and receptive to feedback and change Deciding and initiating action Ethics and Values Managing diverse relationships Adapting to change Communication and writing skills Ability to work independently Meeting and exceeding customer expectations
Skills Time Management Verbal and written communication Problem solving skills Presentation skills Relating to others
Knowledge Extensive understanding of the Discovery Health Product Benefit and process knowledge |
Qualifications & Experience | Essential Matric Afrikaans (Speak and Write) MS Office Knowledge Minimum of 12 months Face-to-face customer service experience Valid driver’s license and own transport
Advantageous Relevant tertiary qualification In-depth knowledge of the Sasolmed product, processes and systems Medical Scheme Industry knowledge and Medical Scheme’s Act knowledge
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EMPLOYMENT EQUITY
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.
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