Quality Assessor

6 months ago

Cape Town, South Africa Health Solutions Full time

**Introduction**Role 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
- 2-3 years of Call Centre experience preferably in a Medical Aid industry
- 2-3 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 problem-solving (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 up-to-date 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 know-how 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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