Clinical Call Centre Agent

6 months ago


Cape Town, South Africa Palesa Mbali Group Full time

To provide professional customer service to the client’s members and brokers by ensuring that all call centre queries are handled to always set performance standards and ensuring prompt resolution of clinical queries within the Non-Clinical Authorisations queue.

**Key Activities**
- Contribute to cost savings within the department to assist with financial goals and targets
- Capture accurate pre-authorisation data on the system
- Correctly escalate complex clinical call
- Meet delivery objectives through working with other team members within and linked to the department / project
- Resolve operational performance variations and problems and escalate unresolved issues to higher levels
- Ensure delivery targets/objectives are met and operate in a supportive manner to achieve successful delivery
- Provide a support function to the Non-Clinical Authorisation team, including:

- Clinical point of view, during a call with a member
- Explaining disclaimers to members
- Validating authorisation requests
- Checking all system validations to ensure an auto-approval
- UMS access to intervene on certain cases
- Use certain documents to evaluate the non-clinical agent's cases loaded and report on the validations not loaded correctly to increase the auto-approval

**Skills**
- Adobe Creative Suite
- Data modelling and evaluation
- Attention to Accuracy and Detail
- Ability to negotiate and influence
- Problem solving and decision making skills
- Customer Focus
- Task Management
- Computer Technology Skills
- Communication Skills
- Business Writing Skills
- Numerical Ability

**Experience and Qualifications**

2 - 3 years clinical call centre experience in the medical aid industry. A formal nursing qualification and registration/enrolment with SANC or a formal healthcare professional qualification (Registered Nurse).

**Company Description** - A formidable company that aims to deliver exceptional services.


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