Medical Schemes jobs in Cape Town, Western Cape

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 clients through various servicing channels (inbound calls, emails, etc.) responding to their needs, concerns and complaints within agreed Service Level Agreements and legislative and compliance requirements.

Requirements

• Matric
• Call Centre experience is preferred
• Minimum 1-year medical experience (doctor's rooms, radiology, hospitals, x-rays, paramedics, confirmation clerk) is essential
• Good understanding of anatomy and physiology
• Good telephone etiquette is essential
• Independent thinker
• Knowledge of healthcare industry is preferred

Duties & Responsibilities

• Maintain quality customer service
• Bin management turnaround within service level agreement.
• Application of policies/protocols related to scheme benefits.
• Benefits in and out of hospital is appropriately controlled.
• Exclusions are correctly and consistently applied.
• Positive relationships are built and maintained with hospitals and providers.
• Appropriate referral to case management team.

Competencies

• Accountability
• Takes responsibility for own work
• Planning Skills
• Customer orientation
• Organization and Attention to Detail
• Is attentive In Basic, Routine, Repetitious Tasks
• Interrelationship skills
• Possess good judgment and decision-making skills.
• Ability to engage people.
• Demonstrates initiative.
• Understands the organization
• Business Writing Skills
• Product Knowledge
• Risk knowledge-demonstrates knowledge and understanding of risk management methodologies, tools, governance structures and regulatory requirements for good management of risk.