Client Services Consultant
4 months ago
**Job Advert Summary**:
An exciting opportunity for a consultant exists in our Client Services Department.
Applications are invited for the above-mentioned position, to be filled as soon as possible.
**Minimum Requirements**:
**Qualifications & Experience**
- Grade 12
- 3-year Tertiary Qualification in any related field.
- **2 years or more experience in a Medical Call Centre environment.**:
- Sound knowledge of the Medical Aid Industry, Scheme Rules & Regulations, ISO and other related legislation.
- Effective business communication & writing skills with exceptional telephone etiquette (Fluency in Afrikaans is advantageous).
- Must be a strong team player and be able to work under pressure.
- Computer literacy and exposure to Medical Administration system will be an added advantage.
- All company, departmental and operational policies, and procedures.
- Computer literate (MS Office)
- Medical Scheme Act, POPI act and PAIA act
- Knowledge of underwriting rules.
- Good knowledge of ICD-10 codes, medical conditions, and terminology.
**Duties and Responsibilities**:
- Maintain a sound knowledge of Scheme Rules, processes, and systems.
- Prepare submission of priority and stale claim requests on behalf of clients.
- Assist with special projects where required.
- Act as a primary liaison between the client services team, scheme members, and company executives, ensuring seamless communication and timely feedback.
- Provide mentorship and support to junior team members, enhancing their skills in customer service and problem resolution.
- Build and maintain rapport with key stakeholders, including scheme members, company executives, and external partners.
- Monitor customer feedback across platforms, proactively identifying and addressing potential issues before escalation.
- Collaborate cross-functionally with other departments to facilitate effective problem-solving and service improvement initiatives.
- Effective and accurate recording and resolution of all enquiries on first contact.
- Live the PPSHA values daily.
- Maintain Service Levels as per agreement with the scheme.
- Other duties as assigned.
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