Key Purpose
Provide support with all Sasolmed queries including but not limited to Claims investigations, benefit limits, new business, chronic medication and general queries such as explaining policy, protocol and benefit decisions Identifying and proposing solutions to processes and service related failures. Building and establishing relationships at all levels to facilitate first time resolution of queries
Key Outputs
Focuses on customer needs through the resolution of queries
Scrutinizes numerical data, verbal data and all other sources of information so as to ensure a thorough investigation into queries presented and produces workable solutions to a range of problems.
Presenting and communicating information effectively so as to ensure clear understanding and buy-in
Establishes good relationships with customers and staff (both internally and externally) to wide and effective networks. Gains clear agreement and commitment from others by persuading, convincing and negotiating.
Resolve highly escalated queries swiftly and efficiently
Coordinating own and team's administration
Ability to draft written responses of an excellent and consistently professional standard in English, occasionally subject to executive and legal scrutiny
Competencies
Behavioral Competencies
Action orientated
Being open and receptive to feedback and change
Deciding and initiating action
Ethics and Values
Managing diverse relationships
Adapting to change
Communication and writing skills
Ability to work independently
Meeting and exceeding customer expectations
Skills
Time Management
Verbal and written communication
Problem solving skills Presentation skills Relating to others
Knowledge
Extensive understanding of the Discovery Health Product Benefit and process knowledge
Qualifications & Experience
Essential
Matric
MS Office Knowledge
Minimum of 12 months Face-to-face customer service experience
Valid driver's license and own transport
Advantageous
Relevant tertiary qualification
In-depth knowledge of the Bankmed product, processes and systems
Medical Scheme Industry knowledge and Medical Scheme's Act knowledge