Medical Advisory Group Services jobs

Introduction

Through our client-facing brands Momentum Group, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members.

Disclaimer

As an applicant, please verify the legitimacy of this job advert on our company career page.

Role Purpose

Deliver professional service to the members through various servicing channels (inbound and outbound calls, emails and walk-in interactions etc.), in order to optimise health outcomes whilst maintaining service level agreements and compliance requirements. Accurately capturing of chronic applications with the required turnaround times.

Requirements

• A National Senior Certificate is essential
• Exposure to the medical scheme industry would be an advantage
• Prior exposure and understanding of ICD-10 coding would be an advantage
• A completed anatomy course would be an advantage
• MS Office / Office 365 proficiency
• 2 – 3 years experience in a call centre or client services environment with proven knowledge of customer service principles and practices.

Duties & Responsibilities

• Engage with members and service providers to resolve queries and facilitate access to benefits within the agreed timelines and according to the documented processes and protocols.
• Facilitate members' access to relevant information pertaining to their medical conditions, managed through the Disease Management and Wellbeing Team as well as their chronic medication.
• Accurately forward all documents for review to the correct operational systems as per the administrative workflows.
• Create and load authorisations as approved by case managers and pharmacists.
• Accurately complete all administrative and reporting requirements within agreed timeframes.
• Management of maternity gift bags including delivery, collection and stock management.
• Assist with call overflow from customer care media channels.
• Assist with projects relating to disease management and wellbeing programmes.
• Identify and report enhancements to systems and processes to improve member experience.
• Take ownership of complaints and ensure they are resolved timeously and effectively
• Provide all stakeholders with the relevant information and documentation as require

Competencies

• Teamwork and collaboration
• Accuracy and attention to detail
• Excellent verbal and written communication
• Service orientation
• Problem-solving
• Displays initiative