Quality Assessor

2 weeks ago

Cape Town, Western Cape, South Africa Health Solutions Full time

IntroductionRole Purpose**- This role offers exciting and challenging opportunities and is aimed at a dynamic, performance-orientated, knowledgeable, and experienced individual who can deliver quality outputs in a high deadline and client-orientated environment. You will be required to work well within a team as well as on your own. An exciting opportunity exists for an experienced staff member to take up a challenging position as a Quality Assessor.

Requirements:

  • Matric or Grade 12 qualification
  • 23 years of Call Centre experience preferably in a Medical Aid industry
  • 23 years of Claims experience and Membership
  • Supervisory experience or quality management experience would be an advantage
  • Fluent in isiXhosa, isiZulu, Sesotho, Setswana, and English
  • Ability to analyse work situations and initiate corrective action (Cognitive capacity)
  • Troubleshooting and problemsolving (creativity)
  • Strong computer skills e.g. MS Word, Excel
  • Proactive individual who sees beyond the obvious and gets positive results thinks outside the box (creativity)

Duties & Responsibilities

Process:

  • Conduct daily quality checks for all Operational areas in the Government Employees Medical Scheme (GEMS) business unit, including reviewing Call centre, Claims, Membership, and Customer Experience.
  • Conduct weekly quality checks of the written work produced by agents and team coaches.
  • Daily monitoring and motivating staff to ensure department quality objectives are met.
  • Keep accurate, complete and uptodate records of staff administration (evaluation scores, agent profiles etc.).
  • Notify team coaches timeously of specific issues to ensure staff are issued with timeous instructions (memos, guidelines etc.).
  • Assist with locating and/or transcribing calls where possible Customer Service Agent (CSA) error has occurred.
  • Attend and participate constructively in a minimum of one meeting per week with team coaches and stakeholder managers.
  • Ensure the timeous completion of investigations and or tasks arising from meetings.
  • Conduct monthly meetings with teams to convey information and motivate call centre agents.
  • Continuously stay abreast of developments in Metropolitan Health Group (MHG), related to Client Services and/or Call
  • Centre/Claims/Customer Experience/Membership by accessing relevant information.
  • Maintain computer literacy to generate clear and concise quality and statistical reports.
  • Keep abreast of call centre/Claims/Membership technology to ensure work methods and procedures are effectively managed.
  • Sound knowledge of GEMS Rules and Benefits.
  • Table quality statistics for all assessments.
  • Table quality statistics for Team Coach Assessments.
  • Table assessment type statistics, trend analysis.

Client:

  • Build and maintain relationships with clients and internal and external stakeholders.
  • Deliver on service level agreements applicable to clients and internal and external stakeholders in order to ensure that client expectations are managed.
  • Make recommendations to improve client service and fair treatment of clients within area of responsibility.
  • Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service
  • Continuously monitor turnaround times and quality standards and resolve issues speedily to enhance client service delivery.
  • Drive client service delivery goal achievement in line with predefined standards in order to ensure that clients receive appropriate advice and after sales service.
  • Manage client query processes and ensure that queries are tracked, accurately resolved and used as a mechanism to improve client service and business processes.

People:

  • Build strong relationships through providing specialist knowhow and leadership to others, expressing positive expectations.
  • Positively influence and manage change and offer specialist support where required.
  • Contribute to continuous innovation through the development, sharing and implementation of new ideas and involvement of colleagues and staff.
  • Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management.
  • Take ownership for driving career development

Finance:

  • Contribute to the development of area specific budgets to minimise expenditure, in alignment with operational plans.
  • Identify solutions to enhance cost effectiveness and increase operational efficiency.
  • Implement and provide input into governance processes, systems and legislation within area of specialisation.
  • Escalate unresolved policy and governance compliance issues via appropriate channels for investigation and resolution purposes
  • Provide input into the risk identification processes development and communicate recommendations in the appropriate forum.

Competencies

  • Ability to remain impartial
  • A high focus on customer satisfaction
  • Ability to maintain cooperative working

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