Walk-in Consultant

Position Purpose : To engage with walk-in members/providers/brokers on all relevant queries. Providing relevant business information and solutions with a view to resolve enquiries on first contact and note in detail all interaction with the client. To also assist with reception and administrative duties including indexing and assistance on digital platforms. Experience: Minimum 5 years call centre experience within the medical industry. Sound understanding of PHA internal processes and business areas. Qualifications: Grade 12, Call Centre, Customer Services certificate /qualification advantageous KEY COMPETENCIES Client service delivery and quality Follow procedures and cooperate with peers and leader for best possible service delivery Compliance and Risk Management Defined legal, statutory and regulatory compliance is maintained at the required standards Operational risk and governance structures, measures and frameworks are complied withand necessary action is taken to address issues, when necessary Contribute to cost savings within the department to assist with financial goals and targets Operating Model Handle telephonic and written queries within standards and service level agreements Correctly route all escalated calls and queries to correct departments Accurately capture data Professionally handle all client communications Assist in other departments when the need arises Meet delivery objectives through working with other team members within and linked to thedepartment / project Resolve operational performance variations and problems and escalate unresolved issuesto higher levels Ensure delivery targets/objectives are met and operate in a supportive manner to achievesuccessful delivery Ensure that payments were processed at correct rate and against available benefits Investigate all documentation, correct where required and link to member’s records Analyse and correct incorrect payments and identify reason for non-payment. Apply Quality Analysis checklist to processing of claims Provide comprehensive and accurate feedback to clients Identify system constraints and escalate accordingly Ensure that quality control targets are met Audit Support Provide audit teams with the information required to define audit scope and high-risk areas to support effective audits. Review and advise on evidence required for audits to ensure the business is prepared for audits. Facilitate audit finding discussions to assist in identifying and planning the implementation of corrective actions Monitor and report on the implementation of corrective actions to ensure audit findings are resolved timeously. Understand interdependence of different systems and processes in area of specialisation and department Assist with reception duties which include:Greet and assist visitors, clients and staff professionally and courteously Answer, screen and forward reception calls, emails and enquiries. Manage the reception area, ensuring it remains tidy, presentable and well-stocked with necessary supplies Handle incoming and outgoing mail and courier services Skills and Abilities Business Writing Skills Communication Skills Problem Solving Attention to Accuracy and Detail Numerical Ability Customer Focus Relevant systems knowledge and application Knowledge Knowledge of scheme rules and contractual negotiations Knowledge and application of relevant legislation Knowledge and application of processes and procedures Note: Company reserves the right to close the advert before specified closing date. PHA has its head office in Westville, KwaZulu-Natal. It operates country-wide with a nationally linked network and uses a robust, flexible, as well as integrated system to ensure efficient and effective administration of membership and benefits. #J-18808-Ljbffr